播散型带状疱疹患者临床资料分析

Clinical data analysis of patients with disseminated herpes zoster

目的探讨播散型带状疱疹的发病诱因、临床特征、治疗方法和预后。方法回顾性分析该科2012年10月至2018年9月16例播散型带状疱疹患者的诊疗情况。结果 16例患者中,10例发病前有受凉劳累病史;11例静脉滴注膦甲酸钠及5例口服泛昔洛韦抗病毒治疗;3例使用普瑞巴林及13例使用加巴喷丁痛治疗;同时辅以免疫调节、营养神经、局部湿敷、光疗等综合治疗。所有患者均痊愈,4例留有后遗神经痛。结论受凉、劳累是播散型带状疱疹重要的发病诱因。静脉滴注膦甲酸钠及口服泛昔洛韦能有效治疗播散型带状疱疹。普瑞巴林及加巴喷丁可明显缓解播散型带状疱疹所致的神经痛。对高龄播散型带状疱疹患者,需警惕后遗神经痛的发生。

Objective To explore the causes,clinical features,treatment and prognosis of disseminated herpes zoster.Methods Retrospective analysis of diagnosis and treatments of 16 cases with disseminated herpes zoster in the hospital from October 2012 to September 2018.Results Ten of the 16 patients had a history of cold and fatigue before onset.For antivirus,11 cases were treated with intravenous foscarnet sodium and 5 cases with oral famciclovir;to reduce pain,3 cases were treated with pregabalin and 13 cases were treated with gabapentin;sametime,the therapies were combined with immunomodulation,neurotrophic treatment local wet compress and phototherapy.All the patients were cured and 4 cases had sequelae neuralgia.Conclusions Cold and fatigue are the main causes of disseminated herpes zoster.Intravenous injection of foscarnet sodium and oral famciclovir can be effective treatments for disseminated herpes zoster.Pregabalin and gabapentin can relieve neuralgia caused by disseminated herpes zoster.For elderly patients with disseminated herpes zoster,we should be vigilant against the occurrence of residual neuralgia.