B超引导下胸椎旁神经阻滞治疗急性带状疱疹肋间神经痛的研究

关键词：带状疱疹  肋间神经痛  B超引导胸椎旁神经阻滞

Keywords:herpes zoster  intercostal neuralgia  ultrasound guided thoracic paravertebral nerve block

摘要：

      摘要 目的：探讨B超引导下胸椎旁神经阻滞在治疗急性带状疱疹肋间神经痛中的临床疗效。 方法：80例胸背部急性带状疱疹伴肋间神经痛患者随机分为两组，每组各40例。A组（对照组）予常规抗病毒及按需口服镇痛药物治疗，B组（试验组）同时接受在B超引导下选择性胸椎旁神经阻滞治疗。观察治疗后7、14及30天两组患者疼痛视觉模拟评分（VAS）、辅助镇痛药用量、不良反应及后遗神经痛（PHN）发生率。 结果：治疗后各观察时间点两组VAS评分均较治疗前降低（P＜0.009），组间比较差异显著，B组明显低于A组（P＜0.05）。辅助镇痛药物用量、PHN发生率B组亦显著低于A组（P＜0.05）。两组均无明显不良反应发生。 结论：B超引导下胸椎旁神经阻滞联合抗毒治疗急性带状疱疹肋间神经痛安全有效，明显优于单纯药物治疗，并可减少后遗神经痛的发生率，值得临床推广应用。

Abstract:

      Abstract Objective: To assess the clinical efficacy of ultrasound guided thoracic paravertebral nerve block for the treatment of chest-back herpes zoster with intercostal neuralgia. Method: Eighty patients who suffered from herpes zoster with intercostal neuralgia were randomly divided into the control group (group A) and test group (group B) with 40 patients for each. Group A were given routine antivirus treatment and analgesics as needed. Group B were given antivirus drugs combined with thoracic paravertebral nerve block under the guidance of ultrasound. Pain VAS scores, consumption of ancillary analgesic drugs, side effects and the incidence of PHN were measured at 7, 14 and 30 days after the end of treatments. Result: Comparing with baseline, the VAS of both groups significantly decreased at each follow-up point after treatment(P＜0.009). And significant lower VAS scores were found in the test group (P＜0.05). The consumption of analgesic and the incidence of PHN in the control group were higher than that in the test group (P＜0.05). Conclusion: Ultrasound guided thoracic paravertebral nerve block combined with antivirus treatment had a better effect on relieving herpes zoster neuralgia and reducing the incidence of PHN. It was worth in clinical promoting.