短时程脊髓电刺激治疗亚急性期带状疱疹性神经痛的短期疗效

Short-term spinal cord electrical stimulation for the treatment of patients with sub-acute herpetic neuralgia

目的观察短时程脊髓电刺激治疗亚急性期带状疱疹性神经痛的短期疗效。方法收集2016年1月至2018年6月贵州省人民医院疼痛科、神经内科收治的亚急性带状疱疹神经痛患者23例,年龄60~80岁,性别不限,行短时程脊髓电刺激治疗,将电极置入硬膜外腔,刺激脊髓后角感觉神经元及后柱传导束,治疗10~14d后拔出电极。评估治疗前后不同时点的VAS评分,采用睡眠质量评分法评估不同时点睡眠质量,并评价治疗后不同时点的疗效。结果术后1、3、7d及1、3个月时VAS评分分别为(1.48±1.27)、(1.35±1.19)、(1.13±0.97)、(2.96±1.94)、(3.34±2.14),较治疗前(6.57±1.53)明显降低,差异有统计学意义(P<0.01)。睡眠质量明显改善,术后各评价时点睡眠质量评分较术前差异有统计学意义(P<0.01);术后1、3、7d、1及3个月总体有效率分别为82.6%(19/23例),87.0%(20/23例),91.3%(21/23例),21.7%(5/23例),17.4%(4/23例)。结论短时程脊髓电刺激治疗亚急性期带状疱疹性神经痛短期效果佳,可迅速降低患者疼痛,明显改善睡眠质量。

Objective To observe the short-term effects of short-term spinal cord electrical stimulation (SCS) for the treatment of patients with sub-acute herpetic neuralgia. Methods Twenty-three patients with sub-acute herpetic neuralgia of both sexes, aged 60-80 years, were treated with short-term spinal electrical cord stimulation from January 2016 to June 2018 in the Department of Pain Medicine and Department of Neurology of Guizhou Provincial People's Hospital. SCS is a neuromodulation method by placing the stimulating electrode in the epidural space and using current to stimulate the posterior horn sensory neurons and posterior column conduction bundle. VAS was assessed before the treatment and at the 1 day, 3 days, 1 week, 1 month and 3 months after the treatment. Sleep quality score was evaluate quality of sleep at different times. Results The pain relief was remarkable at different times after SCS in all patients. The VAS was 1.48±1.27, 1.35±1.19, 1.13±0.97, 2.96±1.94, 3.34±2.14 at 1 day, 3 days, 1 week, 1 month and 3 months after the treatment respectively, with statistical difference compared with the pretreatment (6.57±1.53)(P<0.01). The effective rates were 82.6%(9/23), 87.0%(20/23), 91.3%(21/23), 21.7%(5/23), 17.4%(4/23) at 1 day, 3 days, 1 week, 1 month and 3 months after treatment respectively. The sleep quality scores were significantly increased at different times after stimulation SCS. Conclusion Short-term spinal cord electrical stimulation can alleviate pain and improve the quality of sleep for the patients with sub-acute herpetic neuralgia.