罗哌卡因复合庆大霉素与利多卡因复合糖皮质激素治疗三叉神经痛的疗效对比

A COMPARATIVE STUDY OF GENTAMYCIN MIXED WITH ROPIVACAINE AND LIDOCAINE MIXED WITH GLUCOCORTICOIDS FOR TRIGEMINAL NEURALGIA

目的:比较罗哌卡因复合庆大霉素与利多卡因复合两种常用糖皮质激素(复方倍他米松,曲安缩松)治疗三叉神经痛的早期疗效。方法:126例三叉神经痛患者随机分为三组,分别用罗哌卡因复合庆大霉素、利多卡因复合复方倍他米松或曲安缩松行外周神经阻滞。比较治疗前、治疗后1天、3天、1周、2周、3周及1个月时的治疗效果、各组的治疗次数以及治疗前后卡马西平用量的变化。结果:经治疗后三组各时间点数字评分(NRS)均较治疗前降低,庆大霉素复合罗哌卡因组在治疗后1天、3周、1个月时的NRS值均低于后两组。复方倍他米松组在治疗后3天和1周时NRS值明显低于其余两组。罗哌卡因复合庆大霉素组的有效率明显高于其余两组。复方倍他米松组的治疗次数明显少于另两组。结论:罗哌卡因复合庆大霉素用于治疗三叉神经痛效果较好;糖皮质激素对三叉神经痛亦有一定效果,其中复方倍他米松效果优于曲安缩松。

Objective： To observe the therapeutic effects of gentamycin mixed with ropivacaine and lidocaine mixed with glucocorticoids for trigeminal neuralgia. Methods ：126 patients with trigeminal neuralgia were randomly allocated into three groups to receive nerve block peripherally with ropivacaine mixed with gentamycin in group Ⅰ （n =44） ; with lidocaine mixed with compound betamethasone in group Ⅱ （n = 42） ; with lidocaine mixed with triamcinolone in group Ⅲ （n = 40） ; respectively. The parameters included pain intensity before and 1 d, 3d, 1 w,2w, 3w and 1 m after treatment, pain relief rate and dosage of carbamazepine. The adverse effects were also evaluated. Results：The pain intensity in all groups decreased at each time point. In group Ⅰ , the value of numeric rating scale （NRS） was significantly less than that in the other two groups at 1d,3w and 1m. In group Ⅱ , the value of NRS was significantly less than that in the other groups at 3d and 1w. The effective rate in gentamycin mixed with ropivacaine, Diprospan and triamcinolone groups was 100%, 76.19% and 80% respectively. Conclusion： Gentamycin mixed with ropivacaine is the more suitable for trigeminal neuralgia than compound betamethasone or triamcinolone.