Tajima Keiko, Iseki Masako, Inada Eiichi, Miyazaki Toyo
Department of Anesthesiology and Pain Medicine, Juntendo University of Medicine, Tokyo 113-0033.
Masui. 2009 Feb;58(2):153-9.
Herpes zoster causes acute pain and sometimes leads to postherpetic neuralgia (PHN). The previously reported risk factors of PHN such as old age, allodynia, paresthesia and so on are not based on evidence. Although nerve block is useful to relieve acute pain and recommended for prevention of PHN, evidence is scanty.
The patients with herpes zoster within 3 months after the onset were studied. The patient underwent nerve blocks and proper medical treatment, and were followed for up to one year. The risk factors of PHN were assessed. We evaluated whether nerve block prevented PHN.
A total of 144 consecutive patients were studied. Twenty seven % of patients suffered PHN. Old age (> 65 y. o) and hypesthesia were confirmed to be the risk factors of PHN, whereas the intensity of acute pain was not. Patients who underwent nerve block within 1 month after the onset were less likely to suffer from PHN compared with patients of delayed nerve blocks.
Old age, hypesthesia and delayed nerve blocks were the risk factors of PHN. Nerve blocks in the early phase of herpes zoster may be useful to prevent PHN, particularly in the younger patients.
带状疱疹可引起急性疼痛，有时会导致带状疱疹后神经痛（PHN）。先前报道的PHN危险因素，如老年、感觉异常、感觉减退等，均缺乏证据支持。尽管神经阻滞有助于缓解急性疼痛且被推荐用于预防PHN，但相关证据较少。
对发病后3个月内的带状疱疹患者进行研究。患者接受神经阻滞及适当的药物治疗，并随访长达1年。评估PHN的危险因素。我们评估了神经阻滞是否能预防PHN。
共对144例连续患者进行了研究。27%的患者发生了PHN。老年（>65岁）和感觉减退被确认为PHN的危险因素，而急性疼痛的强度则不是。与延迟进行神经阻滞的患者相比，发病后1个月内接受神经阻滞的患者发生PHN的可能性较小。
老年、感觉减退和延迟进行神经阻滞是PHN的危险因素。带状疱疹早期进行神经阻滞可能有助于预防PHN，尤其是对年轻患者。
