超声引导下肋间神经阻滞治疗胸背部带状疱疹后遗神经痛疗效分析

目的:观察超声引导下肋间神经阻滞治疗带状疱疹后遗神经痛(PHN)的临床疗效.方法:选择60例胸背部PHN病人,随机分为A组和B组,各30例.B组行超声引导下肋间神经阻滞,注射混合镇痛药10 mL(1％罗哌卡因10 mL+维生素B12500μg+去炎舒松25 mg);A组采用盲探神经阻滞,注射相同药物,2组治疗周期均为1周1次,3周为1个疗程.比较2组治疗前后疼痛视觉模拟(VAS)评分和生活质量评分变化幅度及治疗有效率情况.结果:治疗后2组VAS评分均比治疗前显著降低(P<0.01),生活质量评分显著增加(P<0.01).治疗后B组VAS评分降低幅度显著高于A组(P<0.01);在饮食、睡眠、情绪、日常、生活兴趣等生活质量评分增幅显著高于A组(P<0.01);B组痛疼缓解情况亦显著优于A组(P<0.01).结论:在超声引导下肋间神经阻滞治疗胸背部PHN安全有效,准确率高,值得临床推广应用.

Curative effect analysis of intercostal nerve block guided by ultrasound in the treatment of postherpetic neuralgia

Objective:To observe the clinical effects of intercostal nerve block guided by ultrasound in the treatment of postherpetic neuralgia(PHN). Methods:Sixty patients with PHN were randomly divided into the group A and group B(30 cases each group). Group B was treated with intercostal nerve block guided by ultrasound combined with 10 mL of 1％ ropivacaine,500 μg of vitamin B12 and 25 mg of triamcinolone,and group A was treated with simple intercrostal nerve block using the same drug,once a week,3 weeks a course. The scores of risual analogue scale( VAS) and life quality before and after treatment,and effective rate of treatment between two groups were compared. Results:After treatment, the scores of VAS and life quality in two groups significantly decreased and increased compared with before treatment,respectively(P < 0. 01). After treatment,the decreasing degree of VAS score in group B was significantly higher than that in group A(P<0. 01),and the increasing degree of life quality(including diet,sleep,mood,daily life and life interest) score in group B was significantly higher than that in group A(P<0. 01). The pain remittence in group B was significantly better than that in group A after treatment(P<0. 01). Conclusions:The intercostal nerve block guided by ultrasound in treating PHN is safe and high accuracy rate,which is worthy of promotion in clinic.