背根神经节脉冲射频治疗椎体转移瘤根性痛

The therapeutical effect of dorsal root ganglion pulsed radiofrequency in root pain resulting from transferred tumors in vertebras

目的评估背根神经节脉冲射频治疗椎体转移瘤根性痛的有效性和安全性。方法选择椎体转移瘤根性痛患者40例(患者失联3例,肿瘤进展导致死亡3例,肿瘤进展导致无法交流2例,共导致病例缺失8例),最终32例患者成为研究对象,其中P组为背根神经节脉冲射频组15例,B组为背根神经节阻滞组17例。记录两组患者术前及术后静息及活动时VAS评分、生存质量评分、普瑞巴林剂量,同时记录副反应及并发症。结果与术前相比,两组静息、活动时VAS评分均有显著降低(P<0.05),生存质量有显著提高(P<0.05),两组术后静息时VAS评分各时间点差异无统计学意义(P>0.05)。两组术前、术后第1天活动时VAS评分高于术后其他时间点,B组术后90 d活动时VAS评分与术后60 d活动时VAS评分相比,有所升高(P<0.05),其他各时间点活动时VAS评分差异无统计学意义(P>0.05)。两组患者术后普瑞巴林剂量较术前相比均有明显减少(P<0.05),但两者之间差异无统计学意义(P>0.05)。两组恶心呕吐、头晕、便秘、嗜睡、呼吸抑制以及外周水肿不良反应发生率并无明显差异,无明显的肌力下降和感觉障碍(P>0.05)。结论背根神经节脉冲射频和阻滞对于椎体转移瘤根性痛均有明显效果,背根神经节脉冲射频为治疗椎体转移瘤根性痛提供了新的选择。

Objective To evaluate the efficacy and safety of dorsal root ganglion pulsed radiofrequency(DRG-PRF)in the treatment ofroot pain resulting fromvertebral metastases.Methods A total of 40 patients with root pain resultingfrom vertebral metastases were enrolled.Among them,there were 3 patients lost contact,3 patients died due to tumor progression and 2 patients unable to communicate due to tumor progression.In general,there were 8 patients lost.32 patients were randomly assigned to receive either dorsal root ganglion pulsed radiofrequency(P group,n=15)or simple ganglion block(B group,n=17).The visual analogue scale(VAS)during rest and movement,the life quality score(QOL),dose of pregabalin and adverse events were recorded.Results VAS scoresduring rest and movement were decrease significantly and QOL had a more remarkable increase in both groups after treatment(P<0.05).There were no significant difference between the two groups in VAS scores before treatment(P>0.05).VAS scores during movement was higher intwo groups before treatment and VAS score was the highest at the1 th day after treatment than other time points,VAS score during movement was higher in group B at the 90 th day after treatment than at the 60 th day(P<0.05).There were no significant difference at every time points after treatment(P>0.05).The dose of pregabalin were decrease significantly after treatment as compared to before treatment(P<0.05),There were no significant difference between the two groups(P>0.05).No serious complications were observed in two groups.Conclusions Dorsal root ganglion pulsed radiofrequency and simple ganglion block could both relieved root pain for patients suffering from vertebral metastases.Dorsal root ganglion pulsed radiofrequenc provides a new option for the treatment of vertebral metastatic root pain.