超声联合C臂定位胸神经根射频术治疗带状疱疹后神经痛

Efficacy and Safety of Ultrasound-Guided Combined with C-Arm Localized Thoracic Nerve Root Pulsed Radiofrequency for the Treatment of Postherpetic Neuralgia：a retrospective study

摘要:

目的:探讨超声引导联合C型臂定位胸神经根脉冲射频术治疗带状疱疹后神经痛(Postherpetic Neuralgia,PHN)的有效性与安全性。方法:选取2024年6月至2025年5月首都医科大学附属北京朝阳医院疼痛科收治的PHN (胸2-11节段)患者47例,均接受超声引导联合C型臂定位下胸神经根脉冲射频治疗。收集并记录术前、术后2周、4周、12周、24周的疼痛数字评分(NRS)、简明健康调查问卷(SF-12)评分；收集并记录术中C型臂照射次数及并发症发生情况。 结果:术后各时间点NRS评分较术前均显著下降(P＜0.05),SF-12生理健康总评(PCS)及心理健康总评(MCS)评分显著提升(P＜0.05)。术后24周疼痛控制有效率为91.5%(43/47)。术中C型臂照射次数7(2-27)次；所有患者均未发生气胸、血管损伤、神经损伤等并发症。结论:超声引导联合C型臂定位胸神经根脉冲射频术治疗胸段PHN疗效确切,安全性高,兼具精准穿刺与低辐射优势,是一种值得临床推广的微创介入治疗方案。

Abstract:

Objective: To evaluate the efficacy and safety of ultrasound-guided combined with C-arm localized thoracic nerve root pulsed radiofrequency (TNR-PRF) in the treatment of postherpetic neuralgia (PHN). Methods: A total of 47 patients with thoracic segment PHN(segment 2-11) in the Department of Pain Medicine, Beijing Chaoyang Hospital, Capital Medical University from June 2024 to May 2025, undergoing ultrasound-guided combined with C-arm localized thoracic nerve root pulsed radiofrequency treatment were enrolled. Numerical Rating Scale (NRS) scores were recorded before treatment and at 2 weeks, 4 weeks, 12 weeks and 24 weeks postoperatively. Short form-12 health survey (SF-12) scores were recorded preoperatively and at 24 weeks postoperatively. The incidence of adverse reactions was also recorded after treatment. Results: Compared with preoperative levels, NRS scores significantly decreased at all postoperative time points (P ＜0.05). The SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores significantly improved (P ＜ 0.05). The effective rate of pain control at 24 weeks postoperatively was 91.5%(43/47). The number of C-arm exposures during the procedure was 7(2-27). No complications such as pneumothorax, vascular, or nerve injuries occurred. Conclusion: Ultrasound-guided combined with C-arm localized thoracic nerve root pulsed radiofrequency is an effective and safe treatment thoracic segment PHN. It offers the advantages of precise puncture and low radiation exposure, making it a minimally invasive interventional treatment for thoracic segment PHN.