超声引导下胸椎旁神经阻滞治疗胸背部带状疱疹后神经痛的疗效

EFFICACY OF ULTRASOUND-GUIDED THORACIC PARASPINAL NERVE BLOCK IN THE TREATMENT OF POST-HERPETIC NEURALGIA OF THE CHEST AND BACK

目的 探讨超声引导下胸椎旁神经阻滞治疗胸背部带状疱疹后神经痛的疗效。方法 选择2019年7月—2021年7月石家庄中医院收治的78例胸背部带状疱疹患者为研究对象,按照采取的治疗方法不同分为对照组38例和观察组40例。对照组行皮内注射阻滞及普瑞巴林药物治疗,观察组行超声引导下胸椎旁神经阻滞治疗。比较二组治疗前及治疗后7天、30天视觉模拟评分量表(VAS)以评价疼痛缓解程度,比较二组患者治疗后的治疗效果情况,比较二组患者治疗前及治疗后负性情绪(汉密尔顿抑郁量表HAMD及汉密尔顿焦虑量表HAMA)评分情况。结果 治疗前VAS评分、HAMD评分、HAMA评分比较无明显差异(P>0.05),治疗7天及30天后观察组VAS评分均明显低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后观察组HAMD评分、HAMA评分明显低于对照组,差异有统计学意义(P<0.05)。结论 相较于皮内注射阻滞及普瑞巴林药物治疗,超声引导下胸椎旁神经阻滞治疗胸背部带状疱疹后神经痛更有效缓解患者疼痛,提高总的有效治疗效果,并能明显缓解患者负性情绪。

Objective To investigate the efficacy of ultrasound-guided thoracic paraspinal nerve block in the treatment of post-herpetic neuralgia in chest and back.Methods Seventy-eight patients with thoracic and back herpes zoster admitted to Shijiazhuang Hospital of Traditional Chinese Medicine from July 2019 to July 2021 were selected as the observation subjects.According to the treatment adopted,thirty-eight patients in the control group and forty patients in the observation group.The control group received intradermal injection block and pregabalin.The observation group received ultrasound-guided thoracic paravertebral nerve block.The visual analog scale(VAS) was compared between the two groups before and at 7 and 30 days after treatment to evaluate the degree of pain relief.Comparing the treatment effect of the two groups after treatment.The scoresof negative emotion(Hamilton Depression Scale HAMD and Hamilton Anxiety Scale HAMA) before and after treatment were compared between the two groups.Results There were no significant differences in VAS score,HAMD score and HAMA score before treatment(P>0.05).VAS score of the observation group was significantly lower than that of the control group after 7 days and 30 days of treatment,with statistical significance(P<0.05).The total effective rate in observation group was significantly higher than that in control group,the difference was statistically significant(P<0.05).After treatment,HAMD and HAMA scores in the observation group were significantly lower than those in the control group,with statistical significance(P<0.05).Conclusion Compared with intradermal injection block and pregabalin drug therapy,ultrasound-guided thoracic paravertebral nerve block can relieve patients’ pain more effectively,improve the overall effective treatment effect,and significantly relieve patients’ negative emotions.