短時程脊髓電刺激治療神經病理性疼痛的療效觀察

Effectiveness of temporary spinal cord stimulation for the treatment of neuropathic pain

目的觀察短時程脊髓電刺激在治療神經病理性疼痛的療效。方法回顧性分析本院2015年1月~2019年6月期間,採用短時程脊髓電刺激治療的神經病理性疼痛患者的臨床資料,利用視覺模擬評分(VAS)及簡式McGill疼痛問卷(SF-MPQ)評估術前、術後1週、術後4週、術後12週、術後24週的療效。結果本研究入組21例患者,術後1、4、12、24週療效分別與術前比較,VAS、SF-MPQ結果明顯改善,差異有統計學意義(P<0.01);術後各時間點的VAS比較,術後1、4週結果相近,差異無統計學意義(P>0.05),術後12、24週結果相近,差異無統計學意義(P>0.05);術後12、24週VAS較術後1、4週評分增加,差異有統計學意義(P<0.05);術後各時間點SF-MPQ比較,以術後4週改善最明顯,其後依次是術後1週、術後12週、術後24週,SF-MPQ評分均較前一時間點增加,差異有統計學意義(P<0.01)。結論短時程脊髓電刺激可有效減輕神經病理性疼痛,改善患者生活質量,具有臨床應用價值。

Objective To observe the effectiveness of temporary spinal cord stimulation for the treatment of neuropathic pain.Methods The clinical data of patients who suffered from neuropathic pain and had been treated with temporary spinal cord stimulation in our hospital from January 2015 to June 2019 were retrospectively analyzed.Data from the visual analog scale(VAS)and short-form Mcgill pain questionnaire(SF-MPQ)were recorded before treatment and at one week,four weeks,twelve weeks,and twenty-four weeks after treatment to analyze and evaluate the efficacy.Results Twenty-one patients were enrolled in the study.The VAS and SF-MPQ scores at 1 week,4 weeks,12 weeks,and 24 weeks after treatment were significantly decreased compared with those before treatment(P<0.001).In the follow-up period after treatment,the VAS at 1 week was not significantly different from that at 4 weeks,and there was no significant difference between 12 weeks and 24 weeks(P>0.005).The average VAS scores from 12 weeks to 24 weeks were significantly increased compared to the scores from 1 week to 4 weeks(P<0.005).The SF-MPQ scores at 4 weeks were significantly decreased compared with those at 1 week(P<0.01),and the scores rebounded to a greater degree from 12 weeks to 24 weeks.Conclusion Temporary spinal cord stimulation is an effective method for alleviating neuropathic pain;it can improve patients’quality of life and has clinical utility.