超声引导腹横肌平面阻滞联合脉冲射频术治疗腹壁带状疱疹后神经痛的临床效果

Clinical effects of ultrasound-guided transversus abdominis plane block combined with pulsed radiofrequency on abdominal wall postherpetic neuralgia

目的探究超声引导腹横肌平面阻滞联合脉冲射频术治疗腹壁带状疱疹后神经痛(postherpetic neuralgia,PHN)的临床效果。方法选择2015年5月至2019年5月延安大学附属医院收治的86例腹壁PHN患者为研究对象,根据不同治疗方法将入选患者分为试验组和对照组,每组各43例。对照组患者采用脉冲射频术治疗,试验组患者在对照组治疗基础上联合使用超声引导腹横肌平面阻滞治疗。分别于治疗前和治疗2周后采用视觉模拟评分法(visual analogue scale,VAS)评分和睡眠状况自评量表(self-rating scale of sleep,SRSS)评估两组患者的疼痛程度和睡眠质量,并比较两组患者的治疗效果和镇痛满意度。结果两组患者治疗2周后VAS评分和SRSS评分均显著低于本组治疗前(均P<0.05),且试验组患者治疗2周后上述评分均显著低于对照组(均P<0.05)。试验组患者治疗总有效率和镇痛满意度均显著高于对照组(均P<0.05)。结论超声引导腹横肌平面阻滞联合脉冲射频术治疗腹壁PHN可有效缓解患者疼痛,改善睡眠状况,提高临床治疗效果和镇痛满意度。

Objective To explore the clinical effect of ultrasound-guided transversus abdominis plane block combined with pulsed radiofrequency on abdominal wall postherpetic neuralgia(PHN).Method From May 2015 to May 2019,86 patients with abdominal wall PHN in Yan'an University Affiliated Hospital were enrolled in the study.They were divided into experimental group and control group according to the different treatment methods,with 43 cases in each group.Patients in control group were treated with pulsed radiofrequency,and patients in experimental group were treated with ultrasound-guided transversus abdominis plane block based on the treatment of control group.Before and 2 weeks after treatment,the visual analogue scale(VAS)and self-rating scale of sleep(SRSS)were used to evaluate the pain level and sleep quality of the two groups,the patient's treatment effects and analgesia satisfaction were compared between the two groups.Result Two weeks after treatment,the VAS scores and SRSS scores of patients in both groups were significantly lower than those before treatment(all P<0.05),and the above scores of patients in experimental group were significantly lower than those in control group(all P<0.05).The total effective rate and satisfaction rate of analgesia in experimental group were significantly higher than those in control group(all P<0.05).Conclusion Ultrasound-guided transversus abdominis plane block combined with pulsed radiofrequency in the treatment of abdominal wall PHN,can effectively relieve pain,improve patients'sleep status,clinical treatment and analgesia satisfaction.