带状疱疹神经痛与颈腰痛误诊原因分析

Misdiagnosed Causes Analysis of Herpes Zoster Neuralgia and Cervical and Lumbago Pain

目的探讨带状疱疹神经痛与颈腰痛的误诊原因及预防措施。方法对2019年10月—2021年2月带状疱疹神经痛与颈腰痛中误诊3例的临床资料进行回顾性分析。结果本组误诊率为3.33%。1例因带状疱疹后左侧颈肩部疼痛就诊,后出现神经痛,误诊为带状疱疹神经痛,颈椎X线检查后明确诊断为寰枢关节半脱位;1例因带状疱疹后左侧腰背部疼痛就诊,误诊为带状疱疹神经痛,腰椎X线检查后明确诊断为第三腰椎横突综合征;1例因颈部疼痛伴右上肢麻木就诊,误诊为神经根型颈椎病,后出现疱疹,明确诊断为带状疱疹神经痛。3例均采用抗病毒、止痛、营养神经等治疗,1例给予龙氏整脊疗法配合简易牵引治疗,1例给予针刀联合神经阻滞治疗,1例给予毫火针联合围刺治疗。治疗后临床症状消失,痊愈。结论带状疱疹神经痛及颈腰痛的发病形式和部位多样,临床医师在对患者进行诊断时应做到全面细致,防止误诊。

Objective To investigate misdiagnosed causes and preventive measures of herpes zoster neuralgia(HZN)and cervical and lumbago pain.Methods Clinical data of 3 patients misdiagnosed as having HZN and cervical and lumbago pain between October 2019 and February 2021 was retrospectively analyzed.Results The misdiagnosis rate was 3.33%.One patient visited a doctor for left-sidedness neck and shoulder pain after having herpes zoster and later developed neuralgia,which was misdiagnosed as having HZN,and then atlantoaxial subluxation was confirmed after X-ray examination of cervical spine.One patient was diagnosed as having HZN due to left-sidedness lumbar and back pain after having herpes zoster,and then the 3rd lumbar vertebrae syndrome was confirmed after lumbar X-ray examination.One patient visited a doctor for neck pain accompanied by numbness of the right upper limb,and was misdiagnosed as having cervical spondylotic radiculopathy,and then HZN was confirmed after having herpes zoster.All the 3 patients were treated with antiviral,analgesic and trophic nerve treatments.One patient was treated with Long's chiropractic combined with simple traction treatment,one was treated with acupotomy combined with nerve block treatment,and one was treated with millifire needle combined with periacupuncture treatment.After treatment,clinical symptoms disappeared,and all patients were cured.Conclusion HZN and cervical and lumbago pain have various forms and locations,and therefore clinicians should be meticulous and comprehensive in diagnosis of patients so as to prevent misdiagnosis.