个性化护理干预在老年带状疱疹中的应用效果

目的 探讨个性化护理干预在老年带状疱疹中应用对患者疼痛程度和负面情绪的影响.方法 选取某医院2016年7月至2019年7月期间因带状疱疹需治疗的94例老年患者,随机分为观察组和对照组,每组47例.观察组予以个性化护理干预,对照组予以常规护理,比较两组护理后视觉模拟疼痛评分(VAS)、焦虑自评量表(SAS)、抑郁自评量表...     

带状疱疹相关性疼痛全程管理专家共识

带状疱疹是皮肤科和疼痛科的常见病,带状疱疹相关疼痛严重影响患者生活质量,也是患者就诊的最主要原因。目前国内对带状疱疹相关疼痛的诊疗和管理尚存在一定的认识不足。本共识聚焦于建立带状疱疹相关疼痛的标准化诊疗规范,组织国内皮肤科及疼痛科领域专家,以近年国内外发表的重要文献为基础综合分析,提交专家组反复讨论、修改,最终达成本共...     

疼痛目标管理对带状疱疹神经痛患者疼痛程度及睡眠质量的影响

目的 观察疼痛目标管理对带状疱疹神经痛患者疼痛程度及睡眠质量的影响.方法 选择2017年1月至2020年1月某医院收治的带状疱疹神经痛患者102例,采用随机数字表法分为两组,每组51例.对照组采用常规护理,观察组实施疼痛目标管理.比较两组干预前后疼痛及睡眠质量评分.结果 两组干预前疼痛、睡眠质量评分比较,差异无统计学意...     

AIDS合并带状疱疹的临床特征分析及疼痛化护理的应用效果

目的 分析艾滋病(AIDS)合并带状疱疹的临床特征及疼痛化护理的应用效果。方法 选取本院收治的AIDS合并带状疱疹患者(n=48)为观察对象,根据相关临床资料分析其临床特征,采用红紫双色球法将其分为两组,各24例。对照组实施常规护理,观察组在此基础上实施疼痛化护理,比较护理效果。结果 AIDS合并带状疱疹患者皮疹波及面大,呈多发性特征,常伴有局部灼热疼痛感,其中躯干部是皮疹常见的分布部位;腰背部、头颈肩、臀部四肢是常见的疼痛发作部位;常见合并症为丙型肝炎病毒(HCV)感染31.25%(15/48)和梅毒螺旋体感染10.42%(5/48);护理前观察组的疼痛评分(8.23±1.62)分与对照组的(8.17±1.68)分比较无明显差异(P 0.05);观察组护理后7天的疼痛评分(2.53±0.59)分、护理后14天的疼痛评分(1.83±0.56)分低于对照组的(4.91±1.17)分和(2.92±1.63)分(P 0.05)。结论 AIDS合并带状疱疹患者皮疹分布范围广泛,具有多发性、进展快的特点,对患者实施疼痛化护理能够明显减轻患者疼痛感,促进皮损局部修复,预后良好。     

神经阻滞治疗38例带状疱疹疼痛的疗效观察

目的：观察神经阻滞治疗带状疱疹疼痛的临床疗效。方法：将38例带状疱疹患者采用神经阻滞治疗。结果：总有效率为81．57％，治疗后1个月随访病人未发现有后遗神经痛。结论：神经阻滞治疗能明显有效地减轻带状疱疹疼痛。     

利多卡因联合地塞米松治疗带状疱疹疼痛的临床研究

带状疱疹为皮肤科常见病及多发病,尤其早期在基层医院就诊多,历年来解决此疼痛是皮肤科的一难题。目前我们仍未见到一种安全、有效、简单易于操作的治疗方法。关于治疗此病疼痛的方法很多,如针灸疗法、音频疗法、激光照射、     

水痘-带状疱疹病毒抗体与带状疱疹患者疼痛的关系

用酶标SPA法对68例带状疱疹(HZ)和带状疱疹后遗神经痛(PHN)及HZ半年后无PHN的患者的血清中抗水痘-带状疱疹病毒(VZV)抗体进行了检测,并与35例正常人和非HZ患者血清对照.结果显示HZ在发病一周内其抗VZV抗体大都处于低水平,抗体滴度与年龄无关,仅与疼痛程度有关.HZ在发病一周后其抗体滴度明显升高,该滴度与患者年龄、疼痛程度均呈正相关,即年龄越大,抗VZV抗体滴度越高,疼痛程度也越剧烈.无PHN者在发病半年后其抗VZV抗体均降至正常水平,而有PHN的HZ在一年后抗体仍呈高滴度,显示PHN的发生与抗VZV抗体有密切关系.而对照组抗VZV抗体呈阴性或低滴度阳性.     

程序化疼痛护理干预对带状疱疹神经痛患者疼痛及生活质量的影响

目的探讨程序化疼痛护理干预在带状疱疹神经痛患者中的应用价值。方法选择2017年2月至2019年3月于我院治疗的带状疱疹神经痛患者86例,按随机数字表法分为两组,各43例。对照组采取常规护理,观察组在此基础上采取程序化疼痛护理,对比两组干预后疼痛、生活质量及护理满意度。结果观察组干预后疼痛评分为(3.86±1.05)分,低于对照组(4.43±1.02)分;观察组干预后生活质量评分为(3.38±1.82)分,低于对照组(9.52±3.05)分;观察组干预后护理满意度为95.35%,高于对照组76.74%,差异有统计学意义(P 0.05)。结论带状疱疹神经痛患者实施程序化疼痛护理能够有效改善疼痛情况,从而利于提升生活质量,提高护理满意度,值得推广。     

Comparison between famciclovir and valacyclovir for acute pain in adult Japanese immunocompetent patients with herpes zoster

Famciclovir is a guanine analog antiviral drug used commonly for herpes zoster. Efficacy of famciclovir treatment has been reported to be comparable to valacyclovir treatment. Both of these medications reduce the time to complete cessation of zoster‐associated pain including post‐herpetic neuralgia, as compared to acyclovir. We conducted a multicenter, randomized, open clinical trial in order to evaluate the extent of pain relief afforded by these two antiviral drugs during the acute disease phase of herpes zoster. The study group comprised 86 immunocompetent adult patients suffering from herpes zoster, who were treated with either famciclovir or valacyclovir for 7 days. Of these, 55 patients enrolled in this study within 72 h of the onset of the rash and 31 patients after 72 h of the onset. There was a significant reduction in acute herpes zoster pain with famciclovir on day 7 and at 2–3 weeks in both of these patient groups, while with valacyclovir, there was not significant reduction in pain on day 7. Of patients aged 50 years or older, there was a significantly earlier reduction in pain with famciclovir than with valacyclovir. In addition, a significant reduction in the number of patients with pain was observed as early as days 3–4 with famciclovir treatment as compared with valacyclovir treatment. We conclude that famciclovir was superior to valacyclovir in the relief of acute pain of herpes zoster. Accordingly, famciclovir is recommended for herpes zoster patients with moderate symptoms and a visual analog scale score of under 50 mm.     

Relationship between prior knowledge about herpes zoster and the period from onset of the eruption to consultation in patients with herpes zoster

Herpes zoster (HZ) is a common internal infection caused by latent varicella zoster virus. Emergence of antiviral chemotherapy has changed the treatment of HZ dramatically, but the effects of such therapy are documented only in patients who started treatment within 72 h of HZ onset of the eruption. There have been few studies addressing the question of factors that determine early attendance of patients at a clinic. We questioned 256 patients with acute HZ about: (i) date from onset of the eruption to first clinic visit; and (ii) their prior knowledge of HZ. We found a tendency that patients who already knew about HZ had consulted dermatology clinics earlier (P < 0.05). People most commonly obtained information about the disease from friends and family members who had previously had HZ, but not from the Internet or other mass media. Our results indicate that patient education is important for early attendance at dermatology clinics, which in turn, should result in the improved outcome of antiviral chemotherapy and prevention of postherpetic neuralgia.     

Factors influencing pain outcome in herpes zoster: an observational study with valaciclovir

AIM OF THE STUDY: An observational study with valaciclovir was conducted to assess clinical outcome in herpes zoster, especially pain and associated neurological signs and symptoms in relation to a series of demographic and disease characteristics discernible at presentation. The safety and acceptability of valaciclovir for treatment of zoster was assessed in a wide variety of primary care and clinic referral settings. METHODS: In total, 1897 immunocompetent adults with clinically diagnosed, localized acute herpes zoster were enrolled in this international, open-label study of valaciclovir. All subjects received treatment with oral valaciclovir (1000 mg three times daily) for 7 days from entry to the study and were asked to record the presence of zoster-associated pain and abnormal sensations throughout treatment and 6 months' follow-up. They were seen frequently in clinic to verify subjective assessments and for evaluation of rash healing. Safety and tolerability were assessed by adverse event monitoring. RESULTS: Overall, 1191 subjects (63%) were aged > or = 50 years, and 203 (11%) had ophthalmic zoster. Cessation of zoster-associated pain was significantly faster in the younger age group; median times to loss of zoster-associated pain were 23 days and 9 days in the > or = 50 and < 50 years age groups, respectively. Similarly, abnormal sensations resolved significantly more rapidly in the younger subjects; the median duration of abnormal sensations was 31 days in the > or = 50 year olds and 16 days in those aged < 50 years. In cases of ophthalmic zoster, the rate of pain resolution was not different from those with zoster in other dermatomes (median duration of pain 18 vs. 16 days). However, abnormal sensations persisted significantly longer in subjects with ophthalmic zoster than in those with zoster at other sites (47 vs. 22 days). In addition to advancing age, subjects suffering moderate to severe prodromal pain or acute pain during the rash phase were at significantly greater risk of zoster-associated pain and abnormal sensations persisting for longer. Subjects with concomitant neurological disorders were also more likely to develop prolonged abnormal sensations. Valaciclovir treatment was well tolerated, and adverse events were rare and generally mild. CONCLUSION: This study confirmed the prognostic importance of advancing age and the intensity of prodromal or acute pain as risk factors for prolonged zoster-associated pain and persisting abnormal sensations in the affected dermatome. Ophthalmic zoster and pre-existing neurological disorders are also identified as highly significant risk factors for prolonged abnormal sensations in herpes zoster.     

带状疱疹309例临床分析

目的：探讨带状疱疹（Hz）的发病特点、治疗与疱疹后遗神经痛（PHN）的相关性。方法：回顾性分析309例患者的一般资料、临床表现、实验室检查及临床转归。结果：病程及PHN的发生与患者年龄、初诊时间、治疗用药相关。结论：早期治疗、合理用药对缩短病程及防止PHN发生起一定的作用。     

老年带状疱疹60例临床分析

目的 探讨老年带状疱疹的临床特点。方法 选择近6年来我院皮肤科门诊老年带状疱疹60例，中青年带状疱疹81例，就其前驱症状、皮疹分布、后遗神经痛及疗效方面进行比较。结果 老年组有前驱症状者明显高于中青年组（P〈0.01），出现三叉神经受累（P〈0．05）、血疱大疱（P〈0．01）及后遗神经痛（P〈0．01）的几率增高。结论 老年人带状疱疹要早诊断，早治疗，对无激素禁忌证者，应早期适量使用激素。     

Atypical herpes zoster in a patient with AIDS

Objective To report a case of persistent infection by varicella-zoster virus (VZV) in an HIV-infected patient who presented with atypical, hyperkeratotic viral lesions and a partial response to acyclovir. Methods Viral changes found on histopathological examination; definitive diagnosis of VZV infection was established by viral culture. Results Lesions of chronic hyperkeratotic herpes zoster responded partially to acyclovir therapy, and complete resolution was achieved with intravenous foscarnet. Absence of visceral involvement. Conclusion Prolonged acyclovir therapy for herpes virus infections in HIV-seropositive patients may represent an important pathogenic factor for the appearance of atypical clinical forms associated with drug-resistant viral strains.     

45例带状疱疹并脑膜脑炎的回顾性研究

目的：探讨带状疱疹并发脑膜脑炎的相关因素及发病机制。方法：汇集了山东省12家省市级大医院皮肤科及神经内科住院患者的资料，共有45例，从临床及实验室等方面进行了总结分析。结果：认为年龄不是主要因素，各种原因导致的免疫抑制是重要因素，颅神经尤其是三叉神经眼支受累引起脑炎占首位，其次是肋间神经。结论：带状疱疹并发脑膜脑炎的机制是由于VZV直接侵入脑组织，也存在免疫机制，因此在治疗中要合理的运用抗疱疹病毒药物、糖皮质激素及对症治疗，一般预后还是好的。     

Incidence of serum antibody titers against varicella zoster virus in Japanese patients with herpes zoster

Herpes zoster is an internal reactivation of varicella zoster virus following establishment of latent infection in the dorsal root ganglia during primary infection, which presents as chickenpox. Therefore, serologically, herpes zoster patients already have anti‐varicella zoster virus immunoglobulin G at the onset of disease. Hence, positive serum antibody does not confirm the diagnosis of herpes zoster. We retrospectively investigated the incidence of varicella zoster virus‐specific complement fixation in 865 zoster patients at initial presentation to a dermatology clinic. As a result, 66% of patients showed negative complement fixation, with patient numbers decreasing as titer increased. Paired complement fixation tests conducted within a short period showed a marked elevation in titer, and complement fixation titer gradually decreased after a year. Furthermore, incidence showed no correlation with patient age. These observations indicate that the complement fixation titer at first visit is mainly influenced by the duration from onset to presentation at clinic. Our findings indicate that a positive complement fixation result by single‐point testing confirms at least recent onset of herpes zoster, while paired tests can confirm disease when primary tests are negative.     

无环鸟苷及干扰素治疗单纯疱疹和带状疱疹的疗效观察

47例单纯疱疹及带状疱疹病人随机分为无环鸟苷治疗组(12例),干扰素治疗组(21例)及对照治疗组(14例)。三组在年龄及发病时间上经统计学处理无显著性差异(P>0.05)。结果表明:每日肌注5万单位干扰素比外用3％无环鸟苷软膏(或0.1％无环鸟苷药水)和对照治疗组,能明显缩短病程,减轻症状(P<0.001)。