短时程高颈段脊髓电刺激治疗三叉神经下颌支带状疱疹性神经痛疗效观察

Clinical efficacy of short-term high cervical spinal cord stimulation for herpes zoster neuralgia in the mandibular branch of the trigeminal nerve

目的探讨短时程高颈段脊髓电刺激治疗三叉神经下颌支急性、亚急性带状疱疹性神经痛的有效性及安全性。方法回顾性分析中国医科大学附属第一医院疼痛科2018年1月至2020年12月收治的11例三叉神经下颌支分布区急性或亚急性带状疱疹性神经痛、并接受短时程高颈段脊髓电刺激治疗患者的临床资料。分别记录治疗前、治疗后1、4、12和24周疼痛数字评分法(NRS)评分、普瑞巴林用量、匹兹堡睡眠质量指数(PSQI)、SF-12生活质量评分,并记录不良反应的发生情况。结果与治疗前相比,治疗后1、4、12、24周的NRS评分、普瑞巴林用量和PSQI均明显下降,差异有统计学意义(P<0.01);SF-12量表中的生理总得分和心理总得分均明显增加,差异有统计学意义(P<0.01)。所有患者均未发生严重不良反应。结论短时程高颈段脊髓电刺激可有效缓解三叉神经下颌支急性、亚急性带状疱疹性神经痛,减小止痛药物用量,改善患者的睡眠质量及生活质量,临床治疗安全、有效。

Objective To retrospectively observe the clinical efficacy and safety of short-term high cervical spinal cord stimulation for treating acute or subacute herpes zoster neuralgia in the mandibular branch of the trigeminal nerve.Methods In total,11 patients diagnosed with acute or subacute herpes zoster neuralgia in the mandibular branch of the trigeminal nerve treated with short-term high cervical spinal cord stimulation were recruited.The therapeutic effects were evaluated using a numeric rating scale(NRS),the dosage of pregabalin,the Pittsburgh sleep quality index(PSQI),and a 12-item short-form health survey questionnaire(SF-12)before the treatment and at 1,4,12,and 24 weeks follow-ups after treatment.Complications were also recorded.Results The NRS,the dosage of pregabalin,and PSQI at 1,4,12,and 24 weeks after treatment were significantly decreased compared with their pre-treatment baseline(P<0.01).The PCS and MCS of SF-12 significantly improved from before the treatment(P<0.01).No serious complication was observed during the treatment.Conclusion Short-term high cervical spinal cord stimulation provided significant pain relief for patients with acute or subacute herpes zoster neuralgia in the mandibular branch of the trigeminal nerve.It can effectively reduce the dosage of analgesics and improve the quality of sleep and life of patients.The methods can be safely and effectively used in clinical practice.