星状神经节阻滞联合臭氧大自血治疗颈上肢带状疱疹性神经痛的临床效果

Clinical effect of stellate ganglion block combined with ozone macroblood on herpes zoster neuralgia of upper cervical limb

摘要:

目的:观察超声引导下星状神经节阻滞(stellate ganglion block, SGB)联合臭氧大自血治疗颈上肢急性期带状疱疹性神经痛的临床效果。 方法:回顾性分析2021年6月至2023年1月在山西白求恩医院疼痛科住院的颈上肢急性期带状疱疹患者80例,采用随机数字表法将其随机分为两组:对照组(A组)和试验组(B组),每组40 例。两组均采用常规药物治疗及臭氧大自血回输治疗,B组在此基础上联合超声引导下星状神经节阻滞治疗。观察两组患者入院时(T0)、出院时(T1)、出院后1个月(T2)、出院后3个月(T3)的视觉模拟评分(visual analogue scale, VAS)、焦虑自评量表评分(self-rating anxiety scale, SAS)、匹兹堡睡眠指数 (Pittsburgh sleep quality index, PSQI)评分、加巴喷丁剂量变化,观察两组患者带状疱疹后神经痛 (postherpetic neuralgia, PHN) 的发生率、治疗总有效率、不良反应发生情况。结果:与T0时刻相比,两组患者T1、T2、T3时刻的VAS、SAS、PSQI评分均降低(P＜0.05)；与A组相比,B组T1、T2、T3时刻的VAS、SAS、PSQI评分下降更明显,差异有统计学意义(P<0.05)；随着时间的推移,两组患者加巴喷丁用量均逐渐减少(P均＜0.05),与A组相比,B组下降更明显(P＜0.05)；B组患者PHN的发生率、不良反应的发生率均低于A组,差异有统计学意义(P<0.05)；B组患者治疗总有效率高于A组,差异有统计学意义(P<0.05)。结论:超声引导下星状神经节阻滞联合臭氧大自血回输治疗可有效缓解颈上肢急性期带状疱疹性神经痛,减少PHN发生率,有效改善患者睡眠,操作安全,值得临床推荐。

Abstract:

【】 Objective To observe the clinical effect of ultrasound-guided stellate ganglion block (SGB) combined with medical ozone autologous blood transfusion in the treatment of acute herpetic neuralgia of upper cervical limb. Methods A retrospective analysis was performed on 80 patients with acute shingles in the upper extremity who were hospitalized in the Pain Department of Shanxi Bethune Hospital from June 2021 to January 2023, and they were randomly divided into two groups by random number table method: control group (group A) and test group (group B), with 40 cases in each group. Both groups were treated with conventional drug therapy and medical ozone autologous blood transfusion, and group B was treated with ultrasound guided stellate ganglion block. Observe the visual analogue scale (VAS), self-rating anxiety scale (SAS), Pittsburgh sleep quality index (PSQI), gabapentin dose changes in both groups at admission (T0), discharge (T1), 1 month after discharge (T2), and 3 months after discharge (T3). The incidence of postherpetic neuralgia (PHN), the total effective rate and the occurrence of adverse reactions were observed in two groups. Results Compared with T0 moment, VAS, SAS and PSQI scores at T1, T2 and T3 moments were decreased in both groups (P < 0.05). Compared with group A, VAS, SAS and PSQI scores in group B at T1, T2 and T3 were significantly decreased, and the difference was statistically significant (P<0.05). With the passage of time, the dosage of gabapentin in both groups decreased gradually (P < 0.05), and the decrease was more obvious in group B compared with group A (P < 0.05). The incidence of PHN and adverse reactions in group B were lower than those in group A (P<0.05). The total effective rate of group B was higher than that of group A, and the difference was statistically significant (P<0.05). Conclusion Ultrasound-guided stellate ganglion block combined with medical ozone autologous blood transfusion can effectively relieve acute herpes zoster neuralgia of upper cervical limb, reduce the incidence of PHN, effectively improve patients" sleep, and the operation is safe, worthy of clinical recommendation.