皮内注射治疗带状疱疹后神经痛的进一步探讨

Further study of intradermic injection to treat postherpetic neuralgia

目的探讨皮内注射治疗带状疱疹后神经痛的效果。方法疱疹消退后3-6个月,病变局部仍有烧灼样刺痛或跳痛,局部皮损面积较小者,采用皮内注射镇痛液,内含0.5%布比卡因5ml, 弥可保(Methycobal)针剂500μg,0.9%生理盐水10ml,共16ml,行点状包围法或片状包围法注射。每点注入镇痛液0.2-0.4ml,每日注射1次,连续3d,3次为1疗程,一般需要4-6次,最少3次,最多10 次。结果100例患者治疗后,97例痛感完全消失,夜间睡眠改善,生活质量显著提高,随访1年未发现特殊不适。3例患者左上肢病变侵及左腋下,治疗后疼痛消失,但在阴天或劳累后偶有局部跳痛感。结论皮内注射是一种治疗带状疱疹后神经痛的有效、安全且简便的方法。

Objective To study the effect of intradermic injection on the postherpetic neuralgia. Methods 100 patient with burning or beating pain in some involved dermatomic area after 3-6 months of herpes disappearance were treated with analgesic mixture by intradermic injection, which contained 0.5% bupivacaine 5ml, methycobal 500μg and normal saline 10 ml. The patients accepted the injection once a day in three days continuously; for a treatment course, usually 4~6 times, at least 3 times, at most 10 times. Results The pain was fully relieved in 97 cases and their sleep and quality of life were significantly improved. There was no pain relapse in one year follow-up. Three patients with pain expanded from left upper limb to left armpit, slight pain was still sensed casually, especially in cloudy day or being tired. Conclusion Intradermic injection was one of effective, safe method for treatment of postherpetic neuralgia.