周围神经电刺激治疗慢性头痛的疗效分析

Peripheral nerve stimulation for chronic headache

目的探讨周围神经电刺激治疗慢性头痛的疗效。方法回顾性分析我科自2012年3月至2016年4月收治的经周围神经电刺激手术治疗的慢性头痛患者。本研究根据患者头痛分类和性质选择神经刺激靶点。手术分两期进行,若Ⅰ期手术测试有效,Ⅱ期手术植入脉冲发生器。手术前后采用疼痛视觉模拟评分(VAS)评估疗效,平均随访时间为24.2±21.5个月。结果本研究共纳入9名经周围神经电刺激Ⅰ期手术测试的患者,其中5名患者植入脉冲发生器。这5名VAS平均评分由术前的9.5±0.4下降至3.4±1.3,疗效优良率为80%。术后1名患者出现电极移位和排异反应,未出现长期并发症。结论周围神经电刺激能够安全、有效地控制慢性头痛。

Objective To explore the efficacy and safety of peripheral nerve stimulation（PNS）for intractable chronic headache.Methods From March 2012 to April 2016,9 patients with chronic headache underwent PNS in the department of functional neurosurgery of Xuanwu Hospital of Capital Medical University.Selection of target nerves was based on headache diagnosis and pain characteristics.If the trial was success,A permanent peripheral nerve stimulator would be implanted.Primary outcome measure was Visual analogue scale（VAS）.Average follow-up after implantation was 24.2±21.5 months.Results In this study,the analgesic efficacy of PNS was tested in 9 patients.5 trials were recorded successful and these patients received implant pulse generator of PNS.The VAS score of these patients was significantly lower（mean[±SDv,9.5±0.4 vs.3.4±1.3）.80% of patients had excellent or good pain relief.One patient had her lead migration and skin allergic reaction.There were no permanent adverse events.Conclusion PNS is an effective and reversible treatment for chronic headache.