硬膜外和椎旁神经根注药法对带状疱疹后遗神经痛的疗效观察

带状疱疹后遗症神经痛（ＰＨＮ）是急性带状疱疹痊愈４￣６周后患区留有疼痛，它的诊断并不困难，但共疼痛程度剧烈，持续时间长达３￣５年或更长，患者长期遭受疼前的折磨。，生活质量下降。本文报告３４例（平均年龄６７．８岁）胸腰段ＰＨＮ患者使用硬膜外（ＥＡ）和椎旁（ＰＶＩ）注药两种方法缓解疼痛的对比分析结果。ＥＡ组优良为２９．４％，总有效率为５２．９％；ＰＶＩ组优良率为７０．６％，总有效率为８８．２％，两组经

THE THERAPEUTIC EFFECTS OF EPIDURAL ANALGESIA AND PARAVERTEBRAL NERVE ROOT INJECTION ON POSTHERPETIC NEURALGIA

Postherpetic neuralgia (PHN) could be diagnosed if the pain is still in sufferingarea after 4 to 6 weeks of recovery of acute herpes zoster. Thirty -four patients (averageages 67. 8) suffering from PHN were studied on the efficiency of pain relief by epiduralanalgesia (EA) and paravertebral injection (PVI) of nerve root . The average duration ofPHN was about 3 years, but one male 8 years and one female 13 years. Before going to ourPain clinic, all patients had recieved different combined treatments- The patients were devided into 2 groups, group EA and group PVI (17 cases each). Both groups were injected withthe solution containing 0. 2% bupivacaine, 1 % xylocaine, dexamethson 3 to 5 mg and vitamine B12 0. 5 to 1 mg, 3 to 5 ml for each segment- Injection was given once every 5 daysfor a total of injections. The pain relief was evaluated by means of "Visual Analog Scale",the results revealed that the percent of excellent and good in group PVI ws significantlyhigher than that in group EA (70. 6 % and 29. 4 % respectively, P <0. 01 ) and the total effect as well (88. 2% and 52. 9% respectively, P <0. 02). The Pain was killed by onlyone injection in about one fourth (8 cases) of patients of group PVI. The patient of poorpain-relief in group EA were effective by PVI treatment. Our finding suggest that mainpainful location of PHN may be paravertabral area. The caution must be taken during PVIare also discussed in the paper.