不同脉冲射频模式治疗神经源性疼痛的疗效分析

Effects of pulse radiofreqency with different models in the treatment of neuropathic pain

目的分析不同脉冲射频模式治疗神经源性疼痛的疗效。方法选取神经源性疼痛患者92例，随机分为3组，Ⅰ组为脊神经根阻滞组（n=15），Ⅱ组为经椎间孔硬膜外阻滞组（n=15），Ⅲ组为脉冲射频治疗组（n=62），其中Ⅲ组又分为4个不同的脉冲射频模式组。采取视觉模拟评分（VAS）及简式McGill疼痛问卷（SF—MPG）评估术前，术后1周、3个月时的疗效。结果3组术后疼痛均改善（P〈0.05），以Ⅲ组疗效更显著，VAS术前（7．69±0．43），术后1周（3．99±0．61），术后3个月（2．72±0．19）。结论脉冲射频是治疗神经源性疼痛安全、有效的神经调制技术，其疗效优于神经根阻滞及经椎间孔硬膜外阻滞，而脉冲射频4个模式中以温度42℃，时间120s，脉冲持续时间40ms，脉冲频率2Hz，2个射频周期的模式为本研究中最佳治疗模式。

Objective To analyze the effects of pulse radiofreqency with different models in the treatment of neuropathic pain. Methods Ninety-two patients with neuropathic pain were randomly divided into three groups, patients in group Ⅰ （n= 15） were treated by spinal nerve root block, group Ⅱ （n= 15） by intervertebral foramen epidural injection and group Ⅲ（n= 62） by pulse radiofrequency. There were four subgroups in the group Ⅲ according to different models of pulse radiofrequency. VAS and McGill questionnaire were recorded to evaluate the pain level before procedure and at the first week and third month after procedure. Results All the patients underwent significantly the pain relief （P〈0.05）, especially the ones in group Ⅲ, in which more pain was relieved than that in the other groups. VAS was significantly lower at the first week （3.99±0.61） and third month （2. 72± 0.19） after procedure than that before procedure （7. 69±0.43）（P〈0.05）. Conclusion Pulse radiofreqency is a safe and effective nerve modulation technique for the treatment of neuropathic pain, its effect is better than spinal nerve root block and intervertebral foramen epidural block and the best model of pulse radiofreqency is 42~C, duration 120 s, pulse duration 40 ms, frequency 2 Hz and 2 radiofreqency periods.