DSA引导下背根节脉冲射频治疗带状疱疹后神经痛的疗效及安全性

Dosal root ganglion pulsed radiofrequency guided by DSA for postherpetic neuralgia

目的:观察DSA引导下背根节脉冲射频治疗带状疱疹后神经痛的疗效及其安全性。方法:60例带状疱疹后神经痛患者(VAS≥4.0),随机分为A、B两组,每组30例:A组使用加巴喷丁、阿米替林、奥施康定等药物治疗;B组在上述药物治疗的基础上,联合DSA引导下背根节脉冲射频进行治疗。观察患者射频治疗前,治疗后1、7、30、90、180d的疼痛视觉模拟评分(VAS)、奥施康定使用量、药物副作用、治疗并发症等情况。结果:A组患者射频治疗前,治疗后1、7、30、90、180dVAS分别为:(8.2±1.7)、(6.3±1.8)、(4.1±1.4)、(3.2±1.5)、(3.1±1.2)和(2.6±1.1)分。奥施康定使用量分别为:(28.8±5.5)、(35.6±8.5)、(42.3±8.9)、(18.6±4.3)、(10.7±2.4)和(8.1±1.6)mg。B组患者治疗前,治疗后1、7、30、90、180dVAS分别为:(8.1±1.6)、(4.5±1.6)、(3.0±1.2)、(2.1±1.1)、(1.8±0.9)和(1.5±0.9)分。奥施康定使用量分别为:(29.1±5.8)、(17.6±5.4)、(12.4±3.8)、(5.1±1.6)、(6.0±1.3)和(4.2±0.9)mg,组间比较有显著差异(P<0.05),B组药物副作用减轻,无严重并发症。结论:DSA引导下背根节脉冲射频术能迅速减轻疼痛,降低镇痛药使用量并减少其相关副作用,是带状疱疹后神经痛的一种安全、有效的治疗方法。

Objective To observe the efficacy and safety of dosal root ganglion （DRG） pulsed radiofrequency for treating postherpetic neuralgia （PHN） guided by digital subtraction angiography （DSA）. Methods 60 patients with PHN were randomly divided into two groups （each n= 30）. patients in Group A were treated with gabapentin, amitriptyline, and oxycodone, and patients in Group B were treated with DRG pulsed radiofrequency guided by DSA along with the same medicines used in Group A. VAS and oxycodone dosage before and 1 d, 7 d, 30 d, 90 d, and 180 d after treatment, and side effects and complications during the treatment in the two groups were recorded. Results The VAS of patients in Group A and B before and 1 d, 7 d, 30 d, 90 d, 180 d after treatment were （8.2 ± 1.7） vs. （8.1 ± 1.6）, （6.3 ± 1.8） vs. （4.5 ± 1.6）, （4.1 ± 1.4） vs. （3.0 ± 1.2）, （3.2 ± 1.5） vs. （2.1 ± 1.1）, （3.1 ± 1.2） vs. （1.8 ± 0.9）, and （2.6 ± 1.1） vs. （1.5 ± 0.9）, respectively （all P〈0.05）, and the oxycodone dosages were （28.8 ± 5.5） mg vs.（29.1 ± 5.8） mg, （35.6 ± 8.5） mg vs. （ 17.6 ± 5.4） mg, （42.3 ± 8.9） mg vs （12.4±3.8） mg, （18.6±4.3） mgvs. （5.1 _± 1.6） mg, （10.7 -±2.4） mgvs. （6.0±1.3） rag, and （8.1±1.6） mg vs. （4.2 ±0.9） mg, respectively （all P 〈 0.05）. The medicine side effects in Group B were obviously reduced, and no serious complications occurred. Conclusion DRG pulsed radiofrequency guided by DSA could rapidly relieve the pain of patients with PHN, reduce oxycodone dosage and its relative side effects, and may be a safe and effective method for treating PHN.