阿昔洛韦预防性治疗三叉神经显微血管减压术后颜面部带状疱疹的疗效分析

Therapeutic analysis of facial herpes zoster after trigeminal vascular decompression

目的分析三叉神经显微血管减压术后颜面部带状疱疹采用阿昔洛韦行预防性治疗的临床疗效。方法 2014年5月至2017年5月,于廊坊市第四人民医院行三叉神经显微血管减压术的患者中选取128例,随机分为2组,对照组患者术后给予0.9%氯化钠注射液,若出现颜面部带状疱疹,再给予阿昔洛韦;观察组术后即刻给予阿昔洛韦,连续应用5 d,若出现颜面部带状疱疹,继续采用阿昔洛韦治疗,对比2组术后颜面部带状疱疹发生情况、神经痛持续时间、结痂时间以及止疱时间。结果观察组三叉神经显微血管减压术后颜面部带状疱疹发生率为15.63%(10/64),低于对照组的37.50%(24/64),2组带状疱疹发生率差异有统计学意义(P<0.05);观察组神经痛持续时间、结痂时间以及止疱时间分别为(5.62±1.02)d、(3.22±0.28)d、(2.08±1.05)d,短于对照组的(8.96±1.05)d、(5.99±1.06)d、(4.39±1.16)d,观察组视觉模拟疼痛(VAS)评分为(1.02±0.28)分,低于对照组的(3.26±1.25)分,t值分别为8.625 8、6.687 4、13.025 7、9.625 8,P均<0.05;观察组中治愈+显效+有效患者共有9例,临床治疗总有效率为90%,高于对照组的54.17%(13/24),2组间治疗总有效率差异有统计学意义(χ~2=3.968 8,P<0.05)。结论三叉神经显微血管减压术后颜面部带状疱疹采用阿昔洛韦进行预防性治疗的临床疗效显著,可推广。

Objective To analyze the clinical efficacy of acyclovir in the treatment of facial herpes zoster after trigeminal vascular decompression.Methods From May 2014 to May 2017,a total of 128 patients treated with trigeminal microvascular decompression in the Fourth Hospital of Langfang city were recruited and randomly divided into two groups.The control group was given 0.9%sodium chloride injection after operation while acyclovir was given when facial herpes zoster occurred;the observation group was given acyclovir immediately after surgery for 5 days and acyclovir treatment was continued if facial herpes zoster occurred.Post-operative facial herpes zoster,duration of neuralgia,scarring time,and blistering time were compared between these two groups.Results The incidence of facial herpes zoster after trigeminal vascular decompression was 15.63%(10/64)in the observation group,which was lower than that in the control group(24/64,37.50%).Compared with the control group,the patients in the observation group showed shorter duration of neuralgia,crusting time and blistering time,and the VAS score was lower as well.There were significant differences between the two groups with t=8.625 8,6.687 4,13.025 7 and 9.625 8,respectively(P<0.05).Nine patients(90%)in the observation group reached cure or clinical effective,which is higher than that of the control group(13/24,54.17%)(χ~2=3.968 8,P<0.05).Conclusions The efficacy of acyclovir in the treatment of facial herpes zoster after trigeminal vascular decompression is clinically effective.