连续硬膜外阻滞治疗不同年龄带状疱疹后遗神经痛临床观察

发布时间：2018-03-27 09:01

  本文选题：连续硬膜外阻滞　切入点：带状疱疹后遗神经痛　出处：《中国皮肤性病学杂志》2015年06期

【摘要】：目的比较连续硬膜外注射盐酸利多卡因和糖皮质激素(复方倍他米松)对不同年龄段带状疱疹后遗神经痛(PHN)患者的治疗效果。方法选取病程≤3个月的胸腹部PHN患者60例,皮损位于T3~T11脊神经支配区,按年龄将患者分为A组(30例,年龄≤70岁)和B组(30例,年龄70岁)。均根据疼痛的相应脊神经支配节段,行硬膜外腔穿刺置管,连接镇痛泵输注各1 m L盐酸利多卡因和复方倍他米松,连续输注16~21d。分别于治疗前、治疗后1周、2周、4周、8周和3个月时采用视觉模拟评分(VAS)判断疼痛强度,EQ-5D生存质量评分进行测评生存质量。结果与治疗前比较,两组治疗后1周、2周、4周、8周和3个月的VAS评分均显著降低,EQ-5D评分均显著升高(P均0.05)。治疗后2周、4周、8周和3个月时,A组患者VAS疼痛评分明显低于B组的患者(P0.05),即A组疼痛缓解率(90%)明显优于B组的疼痛缓解率(P0.05)。治疗后1周、2周、4周、8周和3个月,B组的患者生存质量评分明显低于A组生存质量评分(P0.05)。结论连续硬膜外阻滞治疗对年龄≤70岁的PHN患者的疗效优于年龄70岁的患者。
[Abstract]:Objective to compare the therapeutic effects of continuous epidural injection of lidocaine hydrochloride and glucocorticoid on patients with postherpetic neuralgia in different age groups. The lesions were located in the spinal innervation area of T3~T11. According to their age, the patients were divided into group A (n = 30) and group B (n = 30) and group B (n = 30). All patients were treated with epidural puncture and catheterization according to the corresponding spinal innervation segment of pain. Lidocaine hydrochloride and compound betamethasone were infused with analgesic pump 1 mL each for 1621 days. Visual analogue scores (VASs) were used to evaluate the quality of life (QOL) of pain intensity and EQ-5D at 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after treatment, and the results were compared with those before treatment. The VAS scores in both groups were significantly lower than those in group B at 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after treatment, and the scores of EQ-5D were significantly increased (P < 0.05). The VAS pain score of group A was significantly lower than that of group B at the end of 4 weeks and 8 weeks and 3 months after treatment, and it was significantly lower in group A than that in group B. The pain relief rate of group A was significantly better than that of group B (P 0.05). The scores of quality of life of patients in group B were significantly lower than those in group A at 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after treatment (P < 0.05). Conclusion continuous epidural block can be used in patients with continuous epidural block. The therapeutic effect on PHN patients 鈮，

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