老年人颌面部带状疱疹30例分析

Herpes zoster(HZ) in oral and maxillofacial region:clinical analysis of 30 consecutive patients

目的:探讨老年人颌面部带状疱疹的临床特点、诊断,旨在对老年人颌面部带状疱疹患者的早期发现及早期治疗。方法:复习2000-06 2011-06我院口腔科收治的60岁以上老年人颌面部带状疱疹30例的临床资料。结果:30例中皮疹首发2例,28例以疼痛为首发,误诊12例,误诊率40.00%。疼痛后1-3天出现皮疹8例,4-6天16例,>1周4例。被误诊的疼痛有三叉神经痛、头部肿瘤、牙髓炎、偏头痛等4种疼痛。以抗病毒、止痛、营养神经等治疗后一般于2周治愈,遗留神经痛3例。结论:老年人颌面部带状疱疹的临床表现早期复杂、多样,正确的诊断,有赖于提高认识,详细询问病史,认真体检,对于发生在颌面部单侧沿神经放射痛又缺乏阳性体征者,应想到带状疱疹的可能。

Objective： To study clinical behavior and diagnosis of elderly with herpes zoster in oral and maxillofacial region, so as to achieve the aim of early detection and treatment. Methods： Clinical data of 30 patients over 60 years of age with herpes zoster in oral and maxillofacial region treated in our hospital from June of 2000 to June of 2001 were collected. Results： There were two in 30 patients whose first syndrome was rash. There were 28 in 30 patients whose first syndrome was pain. 12 cases were misdiagnosed. The rate of misdiagnosis was 40%. The rash appeared after pain in 1-3d,4-6d and more than lweek were 8,16 and 4 cases respectively. The pains misdiagnosed included Trigeminal neuralgia, head cancer, pulpitis, migraine, and so on. The pains were treated by antiviral, analgesic, and neurotrophic methods for two weeks. Three patients left over the neuralgia. Conclusion： The clinical syndromes of herpes zoster （HZ） in oral and maxillofacial region in old patients are complex in early phase. The correct diagnosis depends on awareness-raising,detailed history, careful physical examination. The searchers should think of the possibility of herpes zoster occur in the oral and maxillofacial unilateral along the nerves radiating pain and lack of positive signs.