短时程外周电刺激治疗三叉神经眼支带状疱疹性神经痛的疗效

Temporary peripheral nerve stimulation in the treatment of herpes zoster neuralgia of ophthalmic branch of trigeminal nerve

目的探讨短时程外周电刺激(tPNS)与脉冲射频(PRF)、神经阻滞(NB)治疗三叉神经眼支带状疱疹性神经痛的临床疗效。方法选择我院收治的120例三叉神经眼支带状疱疹性神经痛患者,将其随机分为tPNS组、PRF组和NB组,每组40例。tPNS组采用C型臂透视引导下经皮眶上8触点电极植入术,PRF组采用C型臂透视引导下眶上神经脉冲射频治疗,NB组采用彩超引导下眶上神经阻滞治疗。采用视觉模拟量表(VAS)、简化MPQ疼痛询问量表(SF-MPQ)评定各组治疗前及治疗后1周、2周、1个月、3个月和6个月疼痛缓解情况,比较3组患者治疗前后疼痛改善率。结果tPNS组治疗后疼痛改善率高于PRF组、NB组,差异有统计学意义(P<0.01);PRF组治疗后疼痛改善率高于NB组,差异有统计学意义(P<0.05)。tPNS组和PRF组治疗后1周的镇痛疗效与治疗前比较,差异均有统计学意义(P<0.05),NB组治疗后1周的镇痛疗效与治疗前比较差异无统计学意义(P>0.05)。3组患者治疗后1个月、3个月及6个月的镇痛疗效与治疗前比较差异有统计学意义(P<0.05),tPNS组与PRF组、NB组治疗后的镇痛疗效比较,差异有显著统计学意义(P<0.01)。结论tPNS治疗三叉神经眼支带状疱疹性神经痛具有良好的临床疗效,安全可靠。

Objective To investigate the clinical efficacy of temporary peripheral nerve stimulation(tPNS),pulsed radiofrequency(PRF)and nerve block(NB)in the treatment of herpes zoster neuralgia of ophthalmic branch of trigeminal nerve.Methods A total of 120 patients with herpes zoster neuralgia of ophthalmic branch of trigeminal nerve admitted to our hospital were selected and randomly divided into the tPNS group,the PRF group and the NB group,with 40 cases in each group.The tPNS group was treated with percutaneous supraorbital 8-contact electrode implantation under the guidance of C-arm fluoroscopy,the PRF group was treated with supraorbital nerve pulsed radiofrequency therapy under the guidance of C-arm fluoroscopy,while the NB group was treated with supraorbital nerve block under the guidance of color Doppler ultrasound.The visual analogue scale(VAS)and simplified MPQ pain questionnaire(SF-MPQ)were used to evaluate the pain relief in each group before treatment and 1 week,2 weeks,1 month,3 months and 6 months after treatment.The improvement rates of pain before and after treatment among the three groups of patients were compared.Results The improvement rate of pain in the tPNS group after treatment was higher than those in the PRF group and the NB group,and the differences were statistically significant(P<0.01).The improvement rate of pain in the PRF group after treatment was higher than that in the NB group,and the difference was statistically significant(P<0.05).The analgesic effects of the tPNS group and the PRF group 1 week after treatment were significantly different from those before treatment(P<0.05),while the analgesic effects of the NB group 1 week after treatment were not significantly different from those before treatment(P>0.05).The analgesic effects 1 month,3 months and 6 months after treatment among the three groups were significantly different from those before treatment(P<0.05).The analgesic effects of the tPNS group after treatment were significantly different from those of the PRF group and the NB group(P<0.01)Conclusion tPNS has good clinical efficacy in the treatment of herpes zoster neuralgia of ophthalmic branch of trigeminal nerve,which is safe and reliable.