CT引导下胸背根神经节射频热凝术联合威伐光照射治疗胸背部带状疱疹后神经痛的疗效

Radiofrequency thermocoagulation at thoracic dorsal root ganglion guided by CT combined with Hydrosun(WIRA)for treatment of patients with postherpetic neuralgia

目的:观察CT引导下胸椎背根神经节射频热凝术联合威伐光照射治疗胸背部带状疱疹后神经痛的临床效果。方法:回顾性分析2017年1月至2020年10月在滨州市第二人民医院疼痛科门诊及住院治疗的胸背部带状疱疹后神经痛患者40例,根据治疗方式分为两组:药物组(采用口服药联合威伐光照射治疗)和射频组(采用CT引导下胸椎背根神经节射频术联合威伐光照射治疗),各20例。于治疗前及治疗后1周、1个月、6个月采用疼痛数字等级评分(NRS)对患者的疼痛程度进行评价,用生活质量评分(QOL)评价患者生活质量。比较两组治疗后1周、1个月、6个月时NRS评分以及QOL变化,并记录治疗期间并发症情况。结果:与治疗前比较,治疗后两组患者各评估时点NRS评分均明显改善,差异有统计学意义( P均<0.05),射频组术后各时点NRS评分均低于药物组,差异有统计学意义( P均<0.05);治疗后两组患者各评估时点QOL评分均明显改善,差异有统计学意义( P均<0.05),射频组术后各评估时点QOL评分均低于药物组,差异有统计学意义( P均<0.05);射频组治疗6个月后有效率为100%,而药物组有效率为70%,差异有统计学意义( P<0.05);两组患者均未见严重并发症发生。 结论:CT引导下胸椎背根神经节射频热凝术联合威伐光照射治疗胸背部带状疱疹后神经痛可安全有效缓解疼痛、改善生活质量,并且其疗效较口服药联合威伐光照射治疗更好。

Objective To observe the clinical efficacy of radiofrequency thermocoagulation at thoracic dorsal root ganglion guided by CT,combined with Hydrosun in the treatment of postherpetic neuralgia.Methods Forty patients with postherpetic neuralgia from January 2017 to October 2020 in Shandong Binzhou Second People's Hospital were analyzed,and the patients were divided into the drug group(n=20)and the radiofrequency group(n=20),oral drugs combined with Hydrosun in the drug group and thoracic dorsal root ganglion pulsed,thermocoagulation radiofrequency at thoracic dorsal root ganglion guided by CT combined with Hydrosun in the radiofrequency group.The numerical rating scale(NRS)and quality of life(QOL)scores at 1 week,1 month and 6 months after the treatment were evaluated,and complications after the treatments were also record.Results After the treatment,the NRS and QOL scores were significantly improved in the two groups(all P<0.05),and the NRS and QOL scores at all follow-up points in the radiofrequency group were lower than those in the drug group(all P<0.05).The total effective rates were 70%and 100%in the drug group and the radiofrequency group,respectively(P<0.05).No complication was observed in these two groups.Conclusion Radiofrequency thermocoagulation at thoracic dorsal root ganglion combined with Hydrosun can effectively relieve pain and improve life quality,with a better therapeutic effect than drugs combined with Hydrosun.