选择性神经根阻滞对带状疱疹后神经痛长期预后的疗效。

The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia.

作者信息

Doo A Ram, Choi Jin-Wook, Lee Ju-Hyung, Kim Ye Sull, Ki Min-Jong, Han Young Jin, Son Ji-Seon

机构信息

Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Korea.

Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.

出版信息

Korean J Pain. 2019 Jul 1;32(3):215-222. doi: 10.3344/kjp.2019.32.3.215.

DOI:10.3344/kjp.2019.32.3.215

PMID:31257830

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6615448/

Abstract

BACKGROUND

Several nerve blocks can reduce the incidence of postherpetic neuralgia (PHN) as well as relieve acute zoster-related pain, but the long-term outcome of PHN has not been clearly determined. This study investigated the efficacy of selective nerve root block (SNRB) for herpes zoster (HZ) on the long-term outcome of PHN.

METHODS

We prospectively conducted an interview of patients who had undergone an SNRB for HZ from January 2006 to December 2016 to evaluate their long-term PHN status. The relationship between the time from HZ onset to the first SNRB and the long-term outcome of PHN was investigated.

RESULTS

The data of 67 patients were collected. The patients were allocated to acute (SNRB ≤ 14 days, n = 16) or subacute (SNRB > 14 days, n = 51) groups. The proportions of cured patients were 62.5% and 25.5% in the acute and subacute groups ( = 0.007), respectively. In logistic regression, an SNRB >14 days was the significant predictor of PHN (adjusted odd ratio, 3.89; 95% confidence interval, 1.02-14.93; = 0.047). Kaplan-Meier analysis revealed that time from the SNRB to the cure of PHN was significantly shorter in the acute group (2.4 ± 0.7 yr) than in the subacute group (5.0 ± 0.4 yr; = 0.003).

CONCLUSIONS

An early SNRB during the acute stage of HZ (within 14 days) appears to decrease the incidence and shorten the duration of PHN, with a median of 5.0 years of follow-up.

摘要

背景

几种神经阻滞可降低带状疱疹后神经痛（PHN）的发生率，并缓解急性带状疱疹相关疼痛，但PHN的长期预后尚未明确确定。本研究调查了选择性神经根阻滞（SNRB）治疗带状疱疹（HZ）对PHN长期预后的疗效。

方法

我们前瞻性地对2006年1月至2016年12月期间接受过HZ的SNRB治疗的患者进行了访谈，以评估他们的长期PHN状况。研究了从HZ发病到首次SNRB的时间与PHN长期预后之间的关系。

结果

收集了67例患者的数据。患者被分为急性组（SNRB≤14天，n = 16）或亚急性组（SNRB>14天，n = 51）。急性组和亚急性组的治愈患者比例分别为62.5%和25.5%（P = 0.007）。在逻辑回归中，SNRB>14天是PHN的显著预测因素（调整后的优势比，3.89；95%置信区间，1.02 - 14.93；P = 0.047）。Kaplan-Meier分析显示，急性组从SNRB到PHN治愈的时间（2.4±0.7年）明显短于亚急性组（5.0±0.4年；P = 0.003）。