腰交感神经节射频热凝联合普瑞巴林治疗CRPS的临床观察

摘要

目的：观察腰交感神经节射频热凝联合普瑞巴林（PGB）治疗复合性局部疼痛综合征（CRPS）的临床疗效和安全性。方法选择26例下肢 CRPS 患者，给予腰交感神经节射频热凝术联合口服 PGB。采用视觉模拟评分（VAS）和睡眠质量评分（QS）评估并记录治疗前及治疗后1、7、14、28、56 d 的疼痛变化，并记录患肢皮肤温度变化及不良反应的发生情况。结果与治疗前相比，患者治疗后 VAS 和 QS 评分明显下降（P＜0．05），患肢皮肤温度明显升高（P ＜0．05），治疗后28、56 d 总有效率为88．46％、96．15％。不良反应主要为头晕和嗜睡，均无血管、神经及腹腔脏器损伤等严重并发症的发生。结论腰交感神经节射频热凝联合 PGB 治疗 CRPS 可迅速缓解患者疼痛，改善患者睡眠质量和生活质量。%Objective To observe the efficacy and safety of radiofrequency thermocoagulation of lumbar sympathetic ganglia combined with pregabalin in the treatment of complex regional pain syndrome(CRPS).Methods 26 patients with lower limb CRPS were selected and treated by the radiofrequency thermocoagulation of lumbar sympathetic ganglia combined with oral pregabalin capsule.The visual analogue scale (VAS)and the quality of sleep(QS)were adopted to evaluate the pain change before treatment and on 1,7,14,28,56 d after treatment.The temperature change of lower limb skin and the occurrence situation of adverse reactions were recorded.Results Compared with before treatment,the scores of VAS and QS at different time points after treatment were decreased significantly (P <0.05),the skin temperature of affected lower limb after treatment was increased significantly (P <0.05).The total effective rates on 28,56 d after treatment were 88.46% and 96.15% respectively.The adverse reactions were mainly dizziness and somnolence.No severe complications such as vascular,neural and intra-abdominal organs injury were found in the treatment process.Conclusion The radiofrequency thermocoagulation of lumbar sympathetic ganglia combined with pregabalin in the treatment of CRPS can rapidly alleviate pain,improve the patients′quality of sleep and living.