超声引导下颈交感链脉冲射频治疗头颈部带状疱疹后神经痛

Ultrasound-guided pulsed radiofrequency on cervical sympathetic chain for postherpetic neuralgia in head and neck regions

目的探讨超声引导下颈交感链脉冲射频治疗头颈部带状疱疹后神经痛的有效性及安全性。方法选择2020年6月至2022年6月莆田市第一医院疼痛科收治的三叉神经及颈2、颈3神经分布区的带状疱疹后神经痛患者52例,病程1~3个月。采用随机数字表法分为常规组和射频组,每组26例。射频组在超声引导下行患侧颈交感链双极高场强脉冲射频治疗,常规组行超声引导下穿刺放置射频套管但不进行射频治疗。记录两组患者术前、术后1、30、90、180 d视觉模拟评分(VAS)、匹兹堡睡眠质量指数(PSQI)、健康调查简表(SF-36)评分、镇痛药物使用量及治疗过程中不良反应发生情况。结果两组治疗后各时间点VAS、PSQI较术前明显降低(P<0.05),SF-36较术前明显升高(P<0.05)。射频组治疗后各时间点VAS、PSQI较常规组降低明显(P<0.05),SF-36较常规组也明显升高(P<0.05),镇痛药物使用量也明显较少(P<0.05)。两组患者治疗过程中均未出现明显不良反应。结论超声引导下颈交感链脉冲射频治疗头颈部带状疱疹后神经痛安全有效。

Objective To investigate the efficacy and safety of ultrasound-guided cervical sympathetic chain pulsed radiofrequency for the treatment of patients with postherpetic neuralgia in head and neck.Methods A total of 52 patients with postherpetic neuralgia in the trigeminal nerve or the 2nd,3rd cervical nerve distribution regions,disease course 1-3 months,in the Department of Pain Management,The First Hospital of Putian City affiliated to Putian University,from June 2020 to June 2022,were enrolled.The patients were randomly divided into sham group(n=26)and PRF group(n=26).The patients in PRF group received bipolar high-voltage pulsed radiofrequency under ultrasound guidance on the cervical sympathetic chain,in sham group only the electrodes were placed at the same position,but no radiofrequency energy applied.The VAS,PSQI,SF-36,the dose of analgesics consumption and adverse reactions during the treatment were recorded before operation,1,30,90 and 180 days after operation.Results The VAS,PSQI,consumption of analgesics were significantly lower,and the SF-36 were significantly higher in the PRF group than that in the sham group(all P<0.05).No serious complications happened during the treatment in both groups.Conclusion Ultrasound-guided pulsed radiofrequency at the cervical sympathetic chain could effectively relieve postherpetic neuralgia in head and neck.