超声引导下胸椎旁神经阻滞联合皮神经阻滞对带状疱疹后神经痛的临床疗效观察

Efficacy of ultrasound-guided thoracic paravertebral nerve block combined with cutaneous nerve block in the treatment of post-herpes zoster neuralgia

目的观察超声引导下胸椎旁神经阻滞联合皮神经阻滞对带状疱疹(HZ)后神经痛的临床疗效。方法按随机数字表法将2022年1月至2023年1月在我院治疗的60例HZ后神经痛患者分为两组,每组30例。对照组采用普瑞巴林胶囊治疗,观察组在对照组的基础上采用超声引导下行胸椎旁神经阻滞联合皮神经阻滞治疗,比较两组患者的疼痛程度、睡眠质量、生活质量、普瑞巴林日用剂量及不良反应情况。结果治疗后,两组患者的视觉模拟评分法(VAS)评分、匹兹堡睡眠质量指数(PSQI)评分均低于治疗前,生活质量指数问卷(QL-index)评分均高于治疗前,差异均有统计学意义(均P<0.05);治疗后,两组患者的VAS、PSQI及QL-index评分比较,观察组的VAS、PSQI评分均低于对照组,QL-index评分高于对照组,差异均有统计学意义(均P<0.05)。观察组的普瑞巴林日用剂量少于对照组,不良反应发生率低于对照组,差异均有统计学意义(均P<0.05)。结论HZ后神经痛采用超声引导下胸椎旁神经阻滞联合皮神经阻滞治疗能够减少普瑞巴林日用剂量,降低不良反应发生率,减轻疼痛程度,改善患者睡眠及生活质量。

Objective To observe the clinical effect of ultrasound-guided thoracic paravertebral nerve block combined with cutaneous nerve block on post-herpes zoster(HZ)neuralgia.Methods 60 patients with post-HZ neuralgia treated in our hospital from January 2022 to January 2023 were divided into two groups with 30 cases in each group by random number table method.The control group was treated with pregabalin capsule,and the observation group was treated with ultrasound guided descending thoracic paravertebral nerve block combined with cutaneous nerve block on the basis of the control group.The pain degree,sleep quality,quality of life,daily dose of pregabalin and adverse reactions of the two groups were compared.Results After treatment,the visual analogue scale(VAS)scores and Pittsburgh Sleep Quality index(PSQI)scores of 2 groups were lower than before treatment,and the QL index scores were higher than before treatment,with statistical significance(both P<0.05).After treatment,VAS,PSQI and QL index scores of 2 groups were compared,and VAS and PSQI scores of observation group were lower than those of control group,and QL index scores were higher than those of control group,with statistical significance(all P<0.05).The daily dose of pregabalin in observation group was lower than that in control group,and the incidence of adverse reactions was lower,with statistical significance(all P<0.05).Conclusion Ultrasound guided thoracic paravertebral nerve block combined with cutaneous nerve block can reduce the daily dose of pregabalin,reduce the incidence of adverse reactions,alleviate pain degree,and improve the quality of sleep and life for post-Hz neuralgia.