超声引导肋间神经不同温度射频热凝治疗带状疱疹后神经痛的临床观察

摘要

目的 观察超声引导肋间神经不同温度射频热凝治疗胸部带状疱疹后神经痛的临床效果.方法 选择带状疱疹后神经痛患者80例, 随机分为两组, 每组40例, RF65°组为超声引导下肋间神经65°射频热凝加神经阻滞组, RF70°组为超声引导下肋间神经70°射频热凝加神经阻滞组.观察治疗前、治疗后1d、1周、1个月、3个月的视觉模拟评分 (visual analogue scale, VAS) 、用状态-特质焦虑量表 (STAI) 和匹兹堡睡眠质量指数量表 (PSQI) 评估患者的焦虑和睡眠质量, 观察不良反应, 比较两组指标的差异.结果 两组VAS评分、STAI、PSQI评分, 治疗后均较治疗前下降, 差异有统计学意义 (P0.05) , 未发生气胸、呼吸困难、血气胸及出血等并发症.结论 超声引导下肋间神经65°射频热凝联合神经阻滞术可治疗胸部带状疱疹后神经痛, 且疗效及安全性等同于70°射频热凝.%Objective To observe the clinical effect of ultrasound-guided radiofrequency thermocoagulation of intercostal nerve at different temperatures in the treatment of thoracic postherpetic neuralgia.Methods A total of 80 cases with postherpetic neuralgia were selected and divided randomly into the RF65° group and RF70° group, and each group consisted of 40 cases.The RF65° group received the ultrasound-guided radiofrequency thermocoagulation at the temperature of 65° and nerve block, while the RF70° group was treated with it at 70° and nerve block.Visual Analogue Scale (VAS) , Status-trait Anxiety Scale (STAI) and Pittsburgh Sleep Quality Index (PSQI) were used to observe both groups before treatment, and 1 day, 1 week, 1 month and 3 months after treatment respectively.The adverse reactions were observed and the differences between the two groups were compared statistically.Results The scores of VAS, STAI and PSQI in the two groups were significantly decreased after treatment than before treatment (P0.05) 1 day, 1 week, 1 months and 3 months after treatment and there were no occurrences of such complications as pneumothorax, dyspnea, hemopneumothorax and hemorrhage.Conclusion The ultrasound-guided radiofrequency thermocoagulation at the temperature of 65° combined with nerve block has the same efficacy and safety as that at 70° in the treatment of thoracic postherpetic neuralgia.