清醒状态下计算机断层扫描引导下双针经皮射频热凝治疗舌咽神经痛的疗效分析。

Effectiveness Analysis of Awake Computed Tomography-Guided Double-Needle Percutaneous Radiofrequency Thermocoagulation for the Treatment of Glossopharyngeal Neuralgia.

机构信息

Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.

Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China; Department of Human Anatomy, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan Province, China.

出版信息

Pain Physician. 2024 Sep;27(7):E695-E703.

PMID:39353117

Abstract

BACKGROUND

Percutaneous radiofrequency thermocoagulation (PRT) is an established treatment for glossopharyngeal neuralgia (GPN). However, the effectiveness of conventional single-needle PRT is limited due to the glossopharyngeal nerve's unique anatomical location.

OBJECTIVES

A major objective of our study was to evaluate the effectiveness and long-term outcomes of computed-tomography (CT)-guided double-needle PRT for patients with GPN.

STUDY DESIGN

Retrospective study.

SETTING

Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University.

METHODS

Clinical data from 38 postoperative GPN patients who underwent CT-guided double-needle PRT between October 2019 and September 2022 were retrospectively reviewed and analyzed. Pain severity was assessed using the Barrow Neurological Institute Pain Intensity Scale (BNI-P) score, and anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS).

RESULTS

Thirty-eight GPN patients were treated with CT-guided double-needle PRT, and 28 patients could be contacted for follow-up. Pain was relieved in 23 patients (82.14%) immediately after the PRT procedure. The percentage of patients who experienced persistent pain relief was 85.71% at T2, 85.71% at T3, 89.28% at T4 and 89.28% at T5. Post-procedure complications included dysesthesia in the throat, dysphagia, choking on drinking water, and hoarseness. No mortality was observed during or after PRT procedures. Twelve patients (42.9%) suffered from anxiety, and 16 patients (57.1%) had depression. Postoperative HADS scores showed notable improvements over the preoperative scores.

LIMITATIONS

Because this study was observational and retrospective, there was no detailed evaluation of the patients. Additionally, the study's small sample size and single-center nature may have further contributed to the bias of the results. A multicenter, prospective study with a large sample size should be performed to further investigate the effectiveness of CT-guided double-needle PRT as a GPN treatment.

CONCLUSION

This study's findings suggest that CT-guided double-needle PRT is a safe and effective alternative treatment for GPN.

摘要

背景

经皮射频热凝术（PRT）是治疗舌咽神经痛（GPN）的一种成熟治疗方法。然而，由于舌咽神经的独特解剖位置，传统的单针 PRT 的效果有限。

目的

我们研究的主要目标之一是评估 CT 引导下双针 PRT 治疗 GPN 患者的有效性和长期疗效。

研究设计

回顾性研究。

地点

郑州大学第一附属医院疼痛医学科。

方法

回顾性分析 2019 年 10 月至 2022 年 9 月期间 38 例接受 CT 引导下双针 PRT 的术后 GPN 患者的临床资料。采用巴罗神经研究所疼痛强度量表（BNI-P）评分评估疼痛严重程度，采用医院焦虑抑郁量表（HADS）评估焦虑和抑郁。

结果

38 例 GPN 患者接受 CT 引导下双针 PRT 治疗，28 例可进行随访。23 例（82.14%）患者在 PRT 术后即刻疼痛缓解。T2 时持续疼痛缓解率为 85.71%，T3 时为 85.71%，T4 时为 89.28%，T5 时为 89.28%。术后并发症包括咽喉感觉异常、吞咽困难、饮水呛咳和声音嘶哑。PRT 过程中或之后无死亡病例。12 例（42.9%）患者有焦虑，16 例（57.1%）患者有抑郁。术后 HADS 评分较术前明显改善。