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CT引导下星状神经节脉冲射频刺激治疗面部及上肢带状疱疹后神经痛

CT-Guided Stellate Ganglion Pulsed Radiofrequency Stimulation for Facial and Upper Limb Postherpetic Neuralgia.

作者信息

Ding Yuanyuan, Yao Peng, Li Hongxi, Han Zhenkai, Wang Shimeng, Hong Tao, Zhao Guangyi

机构信息

Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China.

Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Front Neurosci. 2019 Mar 8;13:170. doi: 10.3389/fnins.2019.00170. eCollection 2019.

Abstract

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster, manifesting as a persistent, spontaneous, knife-like pain or paroxysmal burning that seriously affects a patient's quality of life. An effective treatment of PHN is lacking. This retrospective study examined the efficacy and safety of stellate ganglion (SG) pulsed radiofrequency (PRF) on facial and upper limb PHN. Eighty-four patients with PHN on the face or upper limbs were enrolled for the study. Patients were randomly divided into two surgical groups according to the order of enrollment; one group underwent SG block (SG-B group, = 42) and the other underwent SG pulsed radiofrequency (SG-P group, = 42). After surgery, patients were followed at 1 week, 2 weeks, 1 month, 3 months, and 6 months. Observation at each follow-up included basic patient characteristics, visual analog scale (VAS), quality of life (QOL) using Physical Component Summary (PCS), and Mental Component Summary (MCS) to assess, total effective rate, complications and side effects. Compared with preoperative values, VAS decreased in both groups after surgery ( < 0.05). In the SG-B group, VAS increased after 1 month, while in the SG-P group, VAS gradually decreased at later follow-up time points. VAS decreased more significantly in the SG-P group after 1 month ( < 0.05). PCS and MCS increased in both groups after the operation, and the difference was significant compared with preoperative values ( < 0.05). The total effective rates of the SG-B and SG-P groups were 64.3 and 83.3%, respectively. The total effective rate of the SG-P group was higher than that of the SG-B group ( < 0.05). The incidence of complications and side effects in the SG-B group was higher than that in the SG-P group ( < 0.05). SG pulsed radiofrequency treatment of facial and upper limb PHN is safe and effective. It is a treatment method worth promoting.

摘要

带状疱疹后神经痛(PHN)是带状疱疹最常见的并发症,表现为持续性、自发性、刀割样疼痛或阵发性灼痛,严重影响患者的生活质量。目前缺乏有效的PHN治疗方法。本回顾性研究探讨了星状神经节(SG)脉冲射频(PRF)治疗面部及上肢PHN的疗效和安全性。84例面部或上肢PHN患者纳入本研究。根据入组顺序将患者随机分为两个手术组;一组接受星状神经节阻滞(SG-B组,n = 42),另一组接受星状神经节脉冲射频治疗(SG-P组,n = 42)。术后1周、2周、1个月、3个月和6个月对患者进行随访。每次随访观察内容包括患者基本特征、视觉模拟评分(VAS)、采用躯体健康评分量表(PCS)和精神健康评分量表(MCS)评估的生活质量(QOL)、总有效率、并发症及不良反应。与术前值相比,两组术后VAS均降低(P < 0.05)。SG-B组术后1个月VAS升高,而SG-P组在后续随访时间点VAS逐渐降低。术后1个月SG-P组VAS下降更显著(P < 0.05)。两组术后PCS和MCS均升高,与术前值相比差异有统计学意义(P < 0.05)。SG-B组和SG-P组的总有效率分别为64.3%和83.3%。SG-P组总有效率高于SG-B组(P < 0.05)。SG-B组并发症及不良反应发生率高于SG-P组(P < 0.05)。星状神经节脉冲射频治疗面部及上肢PHN安全有效。是一种值得推广的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c1f/6418026/0900888e158b/fnins-13-00170-g001.jpg

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