肋间神经联合瘢痕射频热凝治疗开胸术后疼痛综合征的临床观察

Clinical study of intercostal nerve combined with scar radiofrequency thermocoagulation for the treatment of post-thoracotomy pain syndrome

摘要:

目的：探究肋间神经联合瘢痕射频热凝治疗开胸术后疼痛综合征(post-thoracotomy pain syndrome,PTPS)的疗效及安全性。方法：回顾性分析南京大学医学院附属鼓楼医院2020年10月至2024年4月采用肋间神经射频及/或瘢痕射频热凝术治疗开胸术后疼痛综合征病人,按治疗方案分为瘢痕射频组和联合射频组,记录两组病人的临床资料并进行分析,比较其疗效和安全性差异。结果：联合射频组术后各时间点视觉模拟评分(visual analogue scale, VAS)、炎症因子水平均低于瘢痕射频组,且有效性更高(86.67% vs. 46.15%),两组均未见严重不良反应。结论：肋间神经联合瘢痕射频热凝较单纯瘢痕射频疗效更佳、安全性良好,可作为开胸术后疼痛综合征的有效治疗方法。

Abstract:

Objective: To evaluate the efficacy and safety of intercostal nerve combined with scar radiofrequency thermocoagulation in the treatment of post-thoracotomy pain syndrome (PTPS). Methods: A retrospective analysis was conducted on patients with post-thoracotomy pain syndrome who underwent intercostal nerve radiofrequency and/or scar radiofrequency thermocoagulation at Nanjing Drum Tower Hospital, Nanjing University Medical School, from October 2020 to April 2024. According to the treatment modalities, patients were divided into a scar radiofrequency group and a combined radiofrequency group. Clinical data of the two groups were collected and analyzed to compare their efficacy and safety. Results: At all postoperative time points, the combined radiofrequency group showed significantly lower visual analogue scale (VAS) and inflammatory cytokine levels than the scar radiofrequency group (P<0.05), with a higher efficacy rate (86.67% vs. 46.15%). No serious adverse events were observed in either group. Conclusion: Intercostal nerve combined with scar radiofrequency thermocoagulation demonstrates superior efficacy and good safety compared with scar radiofrequency alone, and may serve as an effective treatment option for PTPS.