超声引导下颈神经根阻滞治疗急性带状疱疹神经痛的临床研究

Clinical Study of Ultrasound-guided Cervical Nerve Root Block in the Treatment of Acute Herpes Zoster Neuralgia

目的:探讨超声引导下颈神经根阻滞(CNRB)治疗急性带状疱疹神经痛(HZN)的临床效果。方法:选择乐平天湖医院2020年7月-2022年6月收治住院的急性HZN患者60例作为观察对象,按随机数字表法分为药物组和CNRB组,各30例。药物组给予药物治疗,CNRB组在药物治疗基础上给予超声引导下CNRB治疗。对比两组疗效、血清疼痛物质、并发症、带状疱疹后神经痛(PHN)发生率。结果:CNRB组的总有效率为93.33%,高于药物组的73.33%(P<0.05);治疗后,CNRB组血清P物质(SP)和肿瘤坏死因子-α(TNF-α)水平均低于药物组(P<0.05);CNRB组、药物组的并发症发生率分别为16.67%、13.33%,组间比较,差异无统计学意义(P>0.05)。随访3个月发现,CNRB组、药物组的PHN发生率分别为3.33%、13.33%,组间比较,差异无统计学意义(P>0.05)。结论:超声引导下CNRB联合药物治疗急性HZN的效果显著,能降低机体疼痛物质水平,缓解患者的疼痛症状,且并发症少,安全性高,但在降低近期PHN发生率上的效果不明显。

Objective:To investigate the clinical effect of ultrasound-guided cervical nerve root block(CNRB)in the treatment of acute herpes zoster neuralgia(HZN).Method:A total of 60 inpatients with acute HZN from July 2020 to June 2022 in Leping Tianhu Hospital were selected as observation subjects and divided into a medication group and a CNRB group according to the random number table method,with 30 cases in each group.The medication group was given medication,and the CNRB group was given ultrasound-guided CNRB treatment on the basis of medication.The curative effect,serum pain substances,complications and incidence of post-herpetic neuralgia(PHN)were compared between the two groups.Result:The total effective rate of 93.33%in the CNRB group was higher than 73.33%in the medication group(P<0.05).After the treatment,the levels of serum substance P(SP)and tumor necrosis factor-α(TNF-α)in the CNRB group were lower than those in the medication group(P<0.05).The complication rates of the CNRB group and the medication group respectively was 16.67%,13.33%,there was no significant difference between the two groups(P>0.05).The patients were followed up for three months and found that the incidence of PHN in the CNRB group and the medication group respectively was 3.33%and 13.33%,there was no significant difference between the two groups(P>0.05).Conclusion:Ultrasound-guided CNRB combined with medication has a significant effect in the treatment of acute HZN,which can reduce the level of pain substances and relieve the pain symptoms of patients,with few complications and high safety,but it has no obvious effect in reducing the incidence of PHN in the near future.