伐昔洛韦联合甲钴胺对三叉神经痛球囊压迫术后单纯疱疹发生的影响

Effect of Valaciclovir Combined with Mecobalamin on Herpes Simplex after Percutaneous Balloon Compression of Trigeminal Neuralgia

目的评估伐昔洛韦联合甲钴胺对三叉神经痛球囊压迫术后单纯疱疹发生的影响。方法分析2019年6月至2022年7月赣州市人民医院疼痛科诊断原发性三叉神经痛患者315例,均行经皮穿刺球囊压迫术(Percutaneous balloon compression,PBC),根据围手术期是否预防使用抗病毒药物,分成3组,常规组(n=97)、伐昔洛韦组(n=110)、伐昔洛韦联合甲钴胺组(n=108)。记录3组患者术后发生疱疹的例数、发生时间、发生部位、疱疹持续时间、脱痂时间以及术后疱疹期疼痛评分(Visual Analogue Method,VAS)最大值。结果3组患者共有93例患者在术后2~3 d发生单纯疱疹,常规组66例(68.04%),主要发生在口周、面颊部、额头及眼周;伐昔洛韦组19例(17.27%),主要以口周及面颊为主;伐昔洛韦联合甲钴胺组8例(7.41%),主要发生在口周;伐昔洛韦联合甲钴胺组发生率要明显低于其他两组,3组疱疹发生率比较具有统计学意义(P<0.05)。联合组疱疹持续时间、脱痂时间早于其他两组,差异具有统计学意义(P<0.05)。3组疱疹发生后VAS评分最大值,联合组低于其他两组,3组比较具有统计学意义(P<0.05)。结论伐昔洛韦联合甲钴胺可降低PBC术后疱疹的发生率,加快疱疹愈合,降低患者疱疹期VAS评分,疗效明显优于伐昔洛韦,可推荐用于PBC患者的常规预防用药方案。

Objective To evaluate the effect of valaciclovir combined with mecobalamin on herpes simplex after percutaneous balloon compression(PBC)of trigeminal neuralgia.Methods A total of 315 patients with primary trigeminal neuralgia diagnosed in the Department of Pain,Ganzhou People's Hospital from June 2019 to July 2022 were analyzed.All patients underwent PBC.Control group(n=97),valaciclovir group(n=110),valaciclovir combined with mecobalamin group(n=108).The number of cases,occurrence time,occurrence location,duration of herpes,esscab removal time and maximum Visual Analogue Method(VAS)of postoperative herpes were recorded.Results A total of 93 patients developed herpes simplex 2 to 3 days after surgery,66 cases(68.04%)in the control group,mainly around the mouth,cheek,forehead and eye.In valaciclovir group,19 cases(17.27%)were mainly around the mouth and cheek.In valaciclovir plus mecobalamin group,8 cases(7.41%)occurred mainly in perioral area.The incidence of herpes in valaciclovir combined with mecobalamin group was significantly lower than that in the other two groups(P<0.05).The herpes duration and eschar removal time in the combined group were earlier than those in the other two groups,and the differences were statistically significant(P<0.05).The VAS score of the three groups after herpes occurrence was the highest,the combined group was lower than the other two groups,and the comparison among the three groups was statistically significant(P<0.05).Conclusion Valaciclovir combined with mecobalamin can reduce the incidence of herpes after PBC,accelerate the healing of herpes,and reduce the VAS score of patients at herpes stage.The curative effect is significantly better than valaciclovir,which can be recommended as a routine prophylactic regimen for PBC patients.