带状疱疹的护理及健康教育

目的:探讨对带状疱疹患者进行护理及健康教育的临床效果。方法:将我院2008年11月～2009年4月收治的带状疱疹患者50例随机分为两组,对照组25例采用常规护理方法,观察组25例在常规护理的基础上加强健康教育,比较分析两组的临床效果。结果:观察组的显效率为88%,略高于对照组的80%,两组间差异无统计学意义P>0.05);观察组的症状消失时间明显短于对照组,两组间差异有统计学意义(P<0.05)。结论:对带状疱疹患者进行常规护理的同时加强健康教育临床效果满意,值得临床推广应用。     

A case of zoster sine herpete presenting with thoracic radicular pain diagnosed by polymerase chain reaction in skin exudate

Varicella zoster virus (VZV) can cause radicular pain in the absence of skin lesions; such cases are referred to as zoster sine herpete (ZSH) and are usually diagnosed by using serological assays or polymerase chain reaction (PCR). An effort is underway to detect VZV DNA in novel specimens rather than conventional samples (e.g., blood or cerebrospinal fluid) for PCR. There are two reports that PCR analysis in the exudate of the auricular skin can be a useful diagnostic tool for the diagnosis of ZSH in patients presenting with cranial nerve paralysis without herpetic eruptions. Here, we report a case of ZSH diagnosed by using PCR analysis of skin exudates in a patient who developed thoracic radicular pain. This is believed to be the first case of ZSH diagnosed using PCR analysis of skin exudate in a patient in whom the cranial nerve was not involved.     

Fatal herpes simplex virus type 2 hepatitis in a heart transplant recipient: a case report and review of the literature

Herpes simplex virus (HSV) hepatitis is often unrecognized clinically with most untreated cases diagnosed postmortem. HSV hepatitis has been reported in solid organ transplant (SOT) recipients, mostly in kidney and liver transplants, and rarely in heart transplant recipients. We describe a fatal case of community‐acquired HSV‐2 hepatitis in a 24‐year‐old heart transplant recipient occurring 3 years after transplant. We also review the literature summarizing HSV hepatitis and the potential role of quantitative HSV polymerase chain reaction monitoring in the SOT population.     

Disseminated neonatal herpes caused by herpes simplex virus types 1 and 2

Disseminated neonatal herpes simplex virus (HSV) infection is characterized by progressive multiple organ failure and high mortality rates. It can result from infection with either HSV-1 or HSV-2. We report a case of disseminated neonatal herpes that was caused by HSV-1 and HSV-2.     

奥卡西平与左乙拉西坦联合阿昔洛韦治疗单纯性疱疹病毒性脑炎继发癫痫患儿的效果比较

目的:比较奥卡西平与左乙拉西坦联合阿昔洛韦治疗单纯性疱疹病毒性脑炎继发癫痫患儿的效果。方法:选取80例单纯性疱疹病毒性脑炎继发癫痫患儿为研究对象,按随机数字表法将其分为观察组(n=40)和对照组(n=40)。对照组采用左乙拉西坦片联合注射用阿昔洛韦治疗,观察组采用奥卡西平片联合注射用阿昔洛韦治疗,比较两组治疗前后血清炎性因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]水平、临床疗效、血清脑源性神经营养因子(BDNF)和血清神经元特异性烯醇化酶(NSE)水平,以及不良反应发生率。结果:治疗后,观察组IL-1β、IL-6和TNF-α水平均低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为95.00%,高于对照组的80.00%,差异统计学意义(P<0.05);观察组BDNF水平高于对照组,NSE水平低于对照组,差异统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P<0.05)。结论:奥卡西平片联合注射用阿昔洛韦治疗单纯性疱疹病毒性脑炎继发癫痫患儿可提高治疗总有效率和BDNF水平,以及降低炎性因子水平和NSE水平,其效果优于左乙拉西坦片联合注射用阿昔洛韦治疗。     

艾灸结合星状神经节阻滞治疗颜面部带状疱疹性神经痛的疗效观察

目的 观察在治疗颜面部带状疱疹性神经痛的过程中给予艾灸结合星状神经节阻滞治疗的安全性 及有效性。方法 通过抽签分组的方式将我院疼痛科2020年6月-2021年3月收治的40例颜面部带状疱疹性神 经痛患者分为参照组（n=20）与治疗组（n=20）,参照组采用单纯星状神经节阻滞治疗,治疗组在参照组基 础上加用艾灸治疗,比较两组中医症状积分、疼痛评分、疱疹改善时间、生活质量评分、患者对颜面部美 观程度的满意度评分及临床疗效。结果 治疗组中医症状积分、疼痛评分及疱疹改善时间均低于参照组（P ＜0.05）;治疗组治疗优良率（95.00%）高于参照组（70.00%）（P＜0.05）;治疗组生活质量评分及患者对 颜面部美观程度的满意度评分高于参照组（P＜0.05）。结论 艾灸结合星状神经节阻滞治疗颜面部带状疱疹 性神经痛的疗效突出,能减轻患者的疼痛程度,改善疱疹症状,提升其生活质量,值得临床应用。     

蜡疗并超短波治疗带状疱疹后遗神经痛13例

目的观察蜡疗并超短波治疗带状疱疹后遗神经痛的疗效,探讨蜡疗并超短波治疗带状疱疹后遗神经痛的作用机理。方法采用熔点为56度的医用白色无水石蜡,使用蜡饼法,每次治疗时间30min,每日1次,20次为1疗程。然后采用超短波治疗法,每次治疗时间15min,每日1次,20次为1疗程。对13例带状疱疹后遗神经痛患者进行治疗。结果13例中治愈9例,好转3例,无效1例,总有效率92.3%。结论蜡疗并超短波治疗带状疱疹后遗神经痛有确切疗效,值得在临床工作中进一步研究和推广。     

Human herpesvirus-8-related Kaposi''s sarcoma after liver transplantation successfully treated with cidofovir and liposomal daunorubicin

The iatrogenic form of Kaposi's sarcoma (KS) is typically observed among transplant recipients, and the most appropriate therapeutic approach (usually including reduction of immunosuppression, specific chemotherapy, and/or administration of antiviral agents against human herpes virus-8) is still controversial. Available experiences on the effect of the anti-herpes viruses drug cidofovir provide conflicting results. Herein, we report the clinical, histological, and virological features of a liver transplant recipient successfully treated with a combined therapy of cidofovir and liposomal daunorubicin, associated with a reduction of the immunosuppressive regimen, for an advanced cutaneous and visceral KS.     

Factors influencing varicella zoster virus infection after allogeneic peripheral blood stem cell transplantation: low-dose acyclovir prophylaxis and pre-transplant diagnosis of lymphoproliferative disorders

Abstract: Varicella zoster virus (VZV) infection is one of the frequent opportunistic infections after allogeneic bone marrow transplantation, with a high incidence of 30–50%. However, no data have been reported on VZV infection after allogeneic peripheral blood stem cell transplantation (PBSCT).
Patients and methods. We report a retrospective analysis of VZV infection in 192 allogeneic PBSCT recipients. Twenty-seven patients (14%) received long-term prophylaxis of low-dose acyclovir (200 mg twice daily orally ≥3 months) for recurrent oral ( n =21) or genital herpes simplex virus infection ( n =5) or for a previous history of recurrent VZV infection ( n =1).
Results. Forty-two patients (22%) developed VZV infections: localized ( n =37) and disseminated infection ( n =5). The incidence of VZV infection at 1 and 3 years was 19.3±3.3% and 36.8±5.2%, respectively. Complications included post-herpetic neuralgia ( n =18, 43%), secondary bacterial infections ( n =3), and intracranial hemorrhage ( n =1) with 2 deaths. A higher risk factor for VZV infection was pre-transplant diagnosis of a lymphoproliferative disorder (LPD): chronic lymphocytic leukemia, Hodgkin's disease, or non-Hodgkin's lymphoma ( P =0.021, 52.5% in LPD vs. 32.6% in non-LPD group). The use of low-dose acyclovir prophylaxis ( P =0.043, 14.7% in acyclovir vs. 41.6% in nonacyclovir group) was found to be protective. Although no VZV infection episodes were noted during the period of acyclovir prophylaxis, 3 episodes of VZV infection were noted after acyclovir cessation.
Conclusion. The incidence of VZV infection after PBSCT was high at 36.8%, with patients transplanted for LPDs at higher risk. The long-term use of low-dose acyclovir may be protective for VZV infection, although it does not completely prevent rebound of late VZV infection.