国际麻醉学与复苏杂志   2020, Issue (6): 5-5
    
不同电压的胸椎旁神经脉冲射频对胸背部带状疱疹后神经痛疗效的影响
孙悦, 季云晶, 吴征元, 刘尧, 汪婷, 申文1()
1.徐州医科大学江苏省麻醉学重点实验室
Effects of thoracic paravertebral pulsed radiofrequency at different voltage on the treatment of thoracic postherpetic neuralgia
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摘要：

目的 观察不同电压的胸椎旁神经脉冲射频（pulsed radiofrequency, PRF）对胸背部带状疱疹后神经痛（postherpetic neuralgia, PHN）疗效的影响。 方法 选取2019年1月至2019年9月于徐州医科大学附属医院疼痛科住院治疗的PHN患者96例，按照随机数字表法分为3组（每组32例）： 45 V脉冲射频组（PRF‑45V组）、55 V脉冲射频组（PRF‑55V组）、65 V脉冲射频组（PRF‑65V组）。3组患者入院后在常规药物治疗基础上分别采用不同电压（45 V、55 V、65 V）的胸椎旁神经PRF治疗（超声引导下）。于治疗后1周、1个月、3个月进行VAS评分、睡眠状况自评量表（Self‑Rating Scale of Sleep, SRSS）、焦虑抑郁评分、加巴喷丁和曲马多用药量的随访评估，记录治疗期间出现的相关并发症，并于治疗后3个月计算治疗总显效率。 结果 3组患者治疗后各时间点的VAS评分、SRSS评分、焦虑抑郁评分均较治疗前显著降低（P<0.05）；PRF‑65V组患者治疗后同时间点的VAS评分、SRSS评分、焦虑抑郁评分、加巴喷丁与盐酸曲马多的用药量等均明显低于PRF‑45V组及PRF‑55V组（P<0.05）；PRF‑45V组与PRF‑55V组比较，治疗后的VAS评分、SRSS评分、焦虑抑郁评分、加巴喷丁与盐酸曲马多的用药量等差异均无统计学意义（P>0.05）；治疗后3个月时PRF‑65V组的总显效率为87.5%，明显高于PRF‑45V组（54.8%）及PRF‑55V组（60.0%）（P<0.05），而PRF‑45V组与PRF‑55V组比较差异无统计学意义（P>0.05）。3组均无严重并发症发生。 结论 电压45 V、55 V、65 V的胸椎旁神经PRF均可安全、有效地治疗PHN，其中以65V治疗效果最佳。
关键词： 脉冲射频； 电压； 带状疱疹后神经痛
Abstract:

Objective To observe the effects of thoracic paravertebral pulsed radiofrequency (PRF) at different voltage on the treatment of thoracic postherpetic neuralgia (PHN). Methods Ninety‑six PHN patients who were admitted into Department of Pain Management, the Affiliated Hospital of Xuzhou Medical University from January 2019 to September 2019 were enrolled. They were divided into three groups according to the random number table method, group PRF‑45V, group PRF‑55V and group PRF‑65V (n=32). All the groups were treated with ultrasound‑guided thoracic paravertebral PRF at different voltages (45 V, 55 V and 65 V) on the basis of routine treatment. Follow‑up assessment was performed to score using the Visual Analogue Scale (VAS), Self‑Rating Scale of Sleep (SRSS), anxiety and depression scale, to record related complications during treatment, and to measure the dosage of gabapentin and tramadol one week, one month, and three months after treatment. The total effective rate was calculated three months after treatment. Results All the groups presented remarkably decreased scores of VAS, SRSS, anxiety and depression at different time points after treatment, compared with those before treatment (P<0.05). The scores of VAS, SRSS, anxiety and depression as well as the dosage of gabapentin and tramadol significantly decreased in group PRF‑65V at each time point after treatment, compared with group PRF‑45V and group PRF‑55V (P<0.05). There was no statistical difference in VAS, SRSS, anxiety and depression scores and the dosage of gabapentin and tramadol between group PRF‑45V and group PRF‑55V (P>0.05). The total effective rate was 87.5% for group PRF‑65V, which was statistically higher than that of group PRF‑45V (54.8%) and group PRF‑55V (60.0%) (P<0.05). There was no statistical difference between group PRF‑45V and group PRF‑55V (P>0.05). No severe complications occurred in each group. Conclusions Thoracic paravertebral PRF at different voltages (45 V, 55 V and 65 V) is a safe and effective approach to treat PHN, where the efficacy of group PRF‑65V is the best.
Key words: Pulsed radiofrequency; Voltage; Postherpetic neuralgia