透视引导下高电压长时程脉冲射频治疗带状疱疹后神经痛效果及其影响因素

Efficacy and impact factors of fluoroscopy-guided high-voltage long-duration pulsed radiofrequency for treating postherpetic neuralgia

目的观察透视引导下高电压长时程脉冲射频(PRF)治疗带状疱疹后神经痛(PHN)效果及其影响因素。方法对74例接受透视引导下高电压长时程PRF治疗的PHN患者观察不良反应及并发症,评估治疗效果,并根据治疗后6个月数字评价量表(NRS)评分较治疗前下降≥50%与否将其分为有效组(n=45)和无效组(n=29);以多因素logistic回归分析观察PRF治疗PHN效果的影响因素。结果74例治疗中均未出现不良反应。完成治疗后1例惊恐发作,经对症治疗后缓解,未见其他明显并发症。相比PRF前[7(6,8)],PRF后即刻[1(0,2)]及6个月后[2(1,7)]NRS评分均显著降低(P均<0.05)。组间患者年龄、体质量指数(BMI)和PHN病程差异均有统计学意义(P均<0.05)。PHN病程、BMI及PRF前NRS评分为PRF治疗PHN效果的影响因素(P均<0.05)。结论透视引导下高电压长时程PRF可明显缓解PHN;PHN病程、BMI及PRF前NRS评分为疗效的影响因素。

Objective To observe the efficacy and impact factors of fluoroscopy-guided high-voltage long-duration pulsed radiofrequency(PRF)for treating postherpetic neuralgia(PHN).Methods Totally 74 PHN patients who underwent fluoroscopy-guided high-voltage long-term PRF were enrolled.The adverse reactions and complications of PRF were observed,and the efficacy of PRF was analyzed.The patients were divided into effective group(n=45)or ineffective group(n=29)according to whether the decrease of numerical rating scale(NRS)score≥50%6 months after treatment compared with that before treatment or not.Multivariate logistic regression analysis was performed,and the impact factors of efficacy of PRF for treating PHN were explored.Results During PRF,no adverse reaction was noticed,though panic attack occurred in 1 patient after returned to the ward but relieved after targeted treatment.No other complication happened.NRS score immediately(1[0,2])and 6 months after PRF(2[1,7])were significantly lower that before PRF(7[6,8])(both P<0.05).Patients'age,body mass index(BMI)and course of PHN were significant different between groups(all P<0.05).Patients'BMI,course of PHN and NRS score before PRF were impact factors of efficacy of PRF for treating PHN(all P<0.05).Conclusion Fluoroscopy-guided high-voltage long-duration PRF could alleviate PHN.Patients'BMI,course of PHN and NRS score before PRF were impact factors for efficacy of PRF.