带状疱疹后遗神经痛治疗中神经阻滞联合脊髓电刺激治疗对患者睡眠质量和疼痛程度的影响

Effect of nerve block combined with spinal cord electrical stimulation on sleep quality and pain degree of patients with postherpetic neuralgia

目的研究带状疱疹后遗神经痛(PHN)治疗中神经阻滞联合脊髓电刺激治疗对患者睡眠质量和疼痛程度的影响。方法本研究方法为回顾性分析,选取2021年1月至2022年12月南方医科大学附属东莞市妇幼保健院麻醉科收治的60例PHN患者为观察对象,参考治疗方式不同分为神经阻滞组(n=20)、脊髓电刺激组(n=20)、联合组(n=20)。比较3组患者治疗前与治疗后1、3、6、12周匹兹堡睡眠质量指数(PSQI)评分、视觉模拟评分法(VAS)与治疗后12周总有效率、不良反应(乏力、视力模糊、嗜睡、头晕、恶心呕吐)发生率。结果治疗前,3组患者PSQI、VAS评分比较,差异无统计学意义(P>0.05);与治疗前比较,3组患者治疗后1、3、6、12周PSQI、VAS评分更低,差异均有统计学意义(P<0.05);治疗后1、3、6、12周,3组患者PSQI、VAS评分比较,差异均有统计学意义(P>0.05),其中脊髓电刺激组、联合组患者PSQI、VAS评分均低于神经阻滞组,联合组PSQI、VAS评分均低于脊髓电刺激组,差异均有统计学意义(P<0.05)。脊髓电刺激组、联合组患者治疗后总有效率分别为95.00%、100.00%,均明显高于神经阻滞组(70.00%),差异均有统计学意义(P<0.05);脊髓电刺激组与联合组患者治疗后总有效率比较,差异无统计学意义(P>0.05)。3组患者总不良反应发生率比较,差异无统计学意义(P>0.05)。结论与单纯神经阻滞和脊髓电刺激治疗相比,神经阻滞联合脊髓电刺激治疗PHN疗效显著,可进一步改善患者睡眠质量,减轻其疼痛,且安全性高。

Objective To study the effects of nerve block combined with spinal cord electrical stimulation on sleep quality and pain degree of patients with postherpetic neuralgia(PHN).Methods This research method was a retrospective analysis.Sixty patients with PHN admitted to Dongguan Maternal and Child Health Hospital Affiliated to Southern Medical University from January 2021 to December 2022 were selected as the observation subjects.They were divided into the nerve block group(n=20),the spinal cord electrical stimulation group(n=20),and the combination group(n=20)according to the different treatment methods.The Pittsburgh Sleep Quality Index(PSQI)score and visual analog scale(VAS)scores before treatment and 1,3,6 and 12 weeks of after treatment,the total effective rate after 12 weeks of treatment and the incidence of adverse reactions(fatigue,blurred vision,lethargy,dizziness,nausea and vomiting)among the three groups were compared.Results There were no statistically significant differences in PSQI and VAS scores among the three groups before treatment(P>0.05);the PSQI and VAS scores of the three groups after 1,3,6,and 12 weeks of treatment were lower than those before treatment,and the differences were statistically significant(P<0.05);after 1,3,6,and 12 weeks of treatment,the PSQI and VAS scores of the three groups were compared,and the differences were statistically significant(P>0.05);among them,the PSQI and VAS scores of the spinal cord electrical stimulation group and the combination group were lower than those of the nerve block group,while the PSQI and VAS scores of the combination group were lower than those of the spinal cord electrical stimulation group,and the differences were statistically significant(P<0.05).The total effective rates of patients in the spinal cord electrical stimulation group and the combination group after treatment were 95.00%and 100.00%,respectively,which were significantly higher than that in the nerve block group(70.00%),the differences were statistically significant(P<0.05);there was no statistically significant difference in the total effective rate between the spinal cord electrical stimulation group and the combination group after treatment(P>0.05).There was no statistically significant difference in the overall incidence of adverse reactions among the three groups of patients(P>0.05).Conclusion Compared with simple nerve block and spinal cord electrical stimulation therapy,nerve block combined with spinal cord electrical stimulation therapy has a significant therapeutic effect on PHN,which can further improve the patient's sleep quality,alleviate their pain,and have high safety.