脉冲射频联合神经阻滞治疗眼睑带状疱疹神经痛

目的：观察脉冲射频联合神经阻滞治疗眼睑带状疱疹神经痛的疗效分析。

方法：2011-01/2014-08张家港市第一人民医院诊治的81例81眼眼睑带状疱疹患者，随机分为A、B、C三组。A组27例，全身静滴阿昔洛韦、地塞米松药物治疗。B组27例，在阿昔洛韦抗病毒药物治疗基础上，复方倍他米松等眶上神经阻滞。C组27例，在阿昔洛韦抗病毒药物治疗基础上，予脉冲射频联合神经阻滞治疗。比较三组治疗前，治疗后1、7、30、90d的疼痛视觉模拟评分(visual analogue scale，VAS)、临床治疗效果、并发症等情况。

结果：A组患者治疗前，治疗后1、7、30、90d VAS分别为8.2±1.5、7.3±1.6、6.5±1.4、6.1±1.1、5.9±0.7； B组患者治疗前，治疗后1、7、30、90d VAS分别为8.2±1.3、6.3±1.1、5.7±0.9、5.1±1.1、4.1±0.7； C组患者治疗前，治疗后1、7、30、90d VAS分别为8.1±1.5、2.1±0.7、2.2±0.8、2.9±0.7、2.7±0.8。C组患者在脉冲射频联合神经阻滞治疗后疼痛明显缓解，在1、3mo后疼痛评分虽略有恢复，但仍明显低于对照组。三组治疗后第1、7、30、90d VAS评分差异有统计学意义(F=10.320、5.207、2.364、2.805，均P<0.05)。C组患者除减轻疼痛外，无严重并发症，例如角膜知觉减退等，并且角膜炎及角膜溃疡发生的可能减少。

结论：脉冲射频联合神经阻滞治疗能迅速减轻疼痛，并减少该疾病引起的并发症，是眼睑带状疱疹神经痛的一种安全、有效的治疗方法。

Curative effect of pulsed radiofrequency combined with nerve block in the treatment of eyelid postherpetic neuralgia

AIM:To analyze the curative effect of pulsed radiofrequency combined with nerve block in the treatment of eyelid postherpetic neuralgia(PHN).

METHODS:Eighty-one patients(81 eyes)with eyelid herpes zoster from January 2011 to August 2014 in our hospital were randomly divided into three groups(27 patients in group A, 27 patients in group B and 27patients in group C). Patients in group A were treated with intravenous infusion of acyclovir and dexamethasone. Patients in group B were treated with intravenous infusion of acyclovir and supraorbital nerve block using compound betamethasonePatients in group C were treated with pulsed radiofrequency and nerve block along with the same medicine acyclovir. Visual analogue scale(VAS)before treatment and 1, 7, 30, 90d after treatments, clinical efficacy and complications during the treatments in the three groups were recorded and analyzed.

RESULTS:The VAS of patients in group A before treatments and 1,7,30,90d after treatments were 8.2±1.5,7.3±1.6,6.5±1.4,6.1±1.1,5.9±0.7repectively; those of group B were 8.2±1.3,6.3±1.1,5.7±0.9,5.1±1.1,4.1±0.7; those of group C were 8.1±1.5,2.1±0.7,2.2±0.8,2.9±0.7,2.7±0.8. Pain of patients in group C relieved quickly after treatments of pulsed radiofrequency combined with nerve block. After 1 and 3mo, the VAS of group C rose a little, but still significantly lower than that of the other groups.At 1, 7, 30 and 90d after treatments, differences on VAS of three groups were statistically significant(F=10.320,5.207,2.364,2.805; P<0.05).Patients in group C had no severe complications, such as corneal hypoesthesia etc. in addition to relieved pain. The occurrence of keratitis and keratohelcosis in group C were reduced.

CONCLUSION:Pulsed radiofrequency combined with nerve block can rapidly relieve the pain of PHN, reduce the complications, and may be a safety and effective method for eyelid postherpetic neuralgia.