超声引导下颈神经根及星状神经节阻滞联合药物治疗带状疱疹后遗神经痛的疗效观察

Efficacy of ultrasound-guided cervical nerve root and stellate ganglion block combined with medical administration for the treatment of postherpetic neuralgia

目的观察超声引导下颈神经根阻滞(CRB)及星状神经节阻滞(SGB)联合药物治疗带状疱疹后遗神经痛(PHN)的临床疗效及安全性。方法选取2016年1月—2019年4月中国人民解放军联勤保障部队第904医院疼痛科确诊的60例头颈部及上肢PHN患者,随机分为对照组和实验组,每组30例。对照组:超声引导下SGB联合药物治疗;实验组:超声引导下CRB及SGB联合药物治疗。比较两组治疗前及治疗后l周、4周、3个月的视觉模拟评分法(VAS)、睡眠自评量表(SRSS)评分、抑郁自评量表(SDS)评分及神经阻滞治疗的安全性。结果治疗前后不同时间点的VAS、SRSS、SDS评分有差异(P?<0.05);治疗前后两组的VAS、SRSS、SDS评分有差异(P<0.05),实验组与对照组比较,VAS、SRSS、SDS评分较低;治疗前后两组的VAS、SRSS、SDS评分变化趋势有差异(P<0.05)。两组患者只有声音嘶哑、轻度头晕的并发症出现,差异无统计学意义(P>0.05)。结论超声引导下CRB及SGB联合药物可有效治疗PHN,是安全的治疗方法。

Objective To evaluate the efficacy and safety of ultrasound-guided cervical nerve root block and stellate ganglion block combined with medical administration on the treatment of postherpetic neuralgia (PHN).Methods Sixty patients diagnosed with PHN in head,neck and upper limbs in the pain department of the 904th Hospital of the Joint Logistic Support Force of PLA were randomly divided into two groups:control group (group C,n=30) with ultrasound-guided stellate ganglion block combined with medical administration,and test group (group S,n=30) with ultrasound-guided cervical nerve root and stellate ganglion block combined with medical administration.The curative effect was evaluated with visual analogue scale (VAS),self-rating scale of sleep (SRSS) and self-rating depression scale (SDS) at the time of pre-treatment,1 week,4 weeks and 3 months after the treatment.And the safety of nerve block therapy was assessed.Results The VAS,SRSS,and SDS scores were different at different time points before and after treatment (P<0.05);VAS,SRSS and SDS scores of the test group were different from those of the control group,and VAS,SRSS and SDS scores of the test group were lower than those of the control group (P<0.05).The variation trends of VAS,SRSS and SDS scores were different between the test group and the control group (P<0.05).Only hoarseness and mild dizziness appeared in the two groups,without statistical significance (P>0.05).Conclusion Ultrasound-guided cervical nerve root and stellate ganglion block combined with medical administration can effectively alleviate pain in patients with PHN,which is a safe treatment.