【2017年整理】威伐光辅助治疗带状疱疹及后遗神经痛的临床观察.doc

[作者简介] 孙德海，男，学士，副主任医师，从事神经病理性疼痛和软组织疼痛研究。联系电话：（0459）5805377，E－mail:mazui35k@126.com 威伐光辅助治疗带状疱疹及后遗神经痛的疗效观察 孙德海 纪春梅 马 玲 李淑丽 姜长林△ (大庆市油田总医院疼痛门诊 黑龙江 大庆163001) THE CLIN ICAL OBSERVATION OF POSTHERPETIC NEURALGIA TREATED W ITH THO- RACIC SYM PATHETIC NERVE RAD IOFREQUENCY COAGULATION GU IDED BY CT HUANG Qiaodong,CHEN Jinsheng, LIUXiaoming, etal 　　【摘　要】　目的　观察威伐光辅助治疗带状疱疹及后遗神经痛的疗效。方法　46例带状疱疹及后遗神经痛患者(VAS≥4.0),随机分为两组,每组23例:A组应用加巴喷丁、路优泰、腺苷钴胺片、盐酸羟考酮控释片等药物治疗; B组在上述药物治疗的基础上,联合威伐光辅助治疗。观察患者威伐光治疗前、治疗后3、7、15及30 d的疼痛程度、盐酸羟考酮控释片使用量、药物副作用、治疗并发症等情况变化。结果　B组患者经威伐光治疗后,患者疼痛明显缓解,盐酸羟考酮控释片使用量明显减少,药物副作用明显减轻,无明显并发症。结论　威伐光能迅速减轻疼痛,可降低镇痛药的使用量，并减少其副作用,是带状疱疹及后遗神经痛的一种安全、有效、无创的辅助治疗方法。 【关键词】　带状疱疹 后遗神经痛　威伐光　 【】　　To observe the effectand complications ofpostherpetic neuralgia(PHN) treatedwith thoracic sympathetic nerve radiofrequency coagulation guided by CT.M ethods　30 PHN patientswere randomly divided into two groups(n=15):GroupA was treated with gabapentin, amitriptyline and oxycodone.Group B was treated with the medicationsmentioned above and sympathetic nerve radiofrequency coagulation guided by CT. VAS before and after treatment, Oxycodone dosage, medication side effects, complicationswere recorded.Results　TheVAS, Oxycodone dosage, medication side effects ofGroup B patientswere obviously reduced.Conclusion　Sympathetic nerve radiofrequency coagulation guided by CT could rapidly relieve PHN patients’pain,reduce oxycodone dosage and its relative side effects, and had no obvious complications. It’s a safe, effective andminimally invasive method treating PHN. 【Key words】　PHN, Radiofrequency coagulation, Sympathetic nerve, Guided by CT 【Author′s address】　The Second Affiliated Hospital ofGuangzhou Medical College, Guangzhou City, Guangdong Province 510260 PRC 带状疱疹(Herpes Zoster,简称HZ),是由水痘带状疱疹病毒在婴幼儿期初次侵犯宿主潜伏于脊神经后根或脑神经节的神经元,遇机体免疫力下降而导致的一种以受累神经分布区剧痛为特征的病毒性疾病。包括带状疱疹神经痛(HZ)和带状疱疹后神经痛(Postherpetic Neuralgia, PHN) 。以往患者就诊时医生多采用药物治疗,神经阻滞，射频神经损毁治疗，均有一定疗效。该病是困扰中老年人群的顽固痛症之一。我院疼痛科在药物治疗的基础上,联合威伐光辅助治疗带状疱疹及后遗神