【摘要】 目的:观察脉冲射频与短时程脊髓电刺激治疗带状疱疹后神经痛(postherpetic neuralgia PHN)的疗效及相关炎性因子的变化。方法:纳入确诊PHN病人40例,按数字随机表分为短时程脊髓电刺激组(A组,n=20)与脉冲射频术组(B组,n=20),观察治疗前后不同时点:术前、治疗后3天、10天、1月、2月、3月的治疗效果及相关炎性因子变化,记录两组病人并发症(气胸、穿刺部位血肿、神经损伤)及卫生经济学指标(手术时间、手术费用、药费、化验检查费、住院总费用及住院天数)。结果:两组病人治疗后简化麦吉尔评分及视觉模拟评分均降低(P <0.05),睡眠质量评分较治疗前显著增加(P <0.01);两组间差异无统计学意义(P> 0.05);治疗后肿瘤坏死因子(tumor necrosis factor TNF) TNF-α、白介素(interleukin IL) IL-1β均低于治疗前(P <0.05);IL-8治疗前后变化差异无统计学意义(P> 0.05)。射频治疗组并发症发生率、手术时间、药费明显高于短时程脊髓电刺激组(P <0.05),手术费用、住院总费用、住院天数明显低于短时程脊髓电刺激组(P <0.05)。结论:两种介入手术均可有效缓解PHN病人临床症状,相关疼痛因子水平均较治疗前降低,射频治疗组不良反应发生率较高。更多还原

【Abstract】 Objective: To investigate the ef?cacy of the spinal cord stimulation and pulsed radiofrequency on treatment of postherpetic neuralgia(PHN). Methods: Forty patients with PHN were divided into spinal cord stimulation group(SCS, A group, n = 20) and pulsed radiofrequency group(B group, n = 20). The short-form Mc Gill pain questionnaire(SF-MPQ) and sleep quality scores were used for evaluation of pain degree and sleep quality before treatment(T0)and at different time points after treatment(T1: 3 days later,T2: 10 days later, T3: 1 st month, T4: 2 nd month and T5: 3 rd month). Side effects(pneumothorax, hematoma, nerve injury) and medical economic parameters(time of operation, cost of operation, cost of drugs, cost of examinations, total costs, time of hospital stay) were recorded. Results: Compared with T0, the SF-MPQ and visual analogue scale(VAS) score of 2 groups were signi?cantly decreased at different time points after treatment(P < 0.01), and the sleep quality scores were signi?cantly increased at different time points(P < 0.01). Compared with T0, the levels of serum TNF-α and IL-1β were reduced after treatment; IL-8 were not changed compared with pre-operation. Side effect rates, time of operations and cost of drugs of B group were signi?cantly higher than those of A group, cost of operation, total cost, time of hospital stay were markedly reduced than A group. Conclusion: The spinal cord stimulation and pulsed radiofrequency can signi?cantly alleviate postherpetic neuralgia pain and enhance quality of sleep. Pulsed radiofrequency treatment has a higher side effect rates.更多还原