本文選題：連續(xù)硬膜外阻滯　切入點：帶狀皰疹后遺神經(jīng)痛　出處：《中國皮膚性病學雜志》2015年06期

【摘要】：目的比較連續(xù)硬膜外注射鹽酸利多卡因和糖皮質(zhì)激素(復(fù)方倍他米松)對不同年齡段帶狀皰疹后遺神經(jīng)痛(PHN)患者的治療效果。方法選取病程≤3個月的胸腹部PHN患者60例,皮損位于T3~T11脊神經(jīng)支配區(qū),按年齡將患者分為A組(30例,年齡≤70歲)和B組(30例,年齡70歲)。均根據(jù)疼痛的相應(yīng)脊神經(jīng)支配節(jié)段,行硬膜外腔穿刺置管,連接鎮(zhèn)痛泵輸注各1 m L鹽酸利多卡因和復(fù)方倍他米松,連續(xù)輸注16~21d。分別于治療前、治療后1周、2周、4周、8周和3個月時采用視覺模擬評分(VAS)判斷疼痛強度,EQ-5D生存質(zhì)量評分進行測評生存質(zhì)量。結(jié)果與治療前比較,兩組治療后1周、2周、4周、8周和3個月的VAS評分均顯著降低,EQ-5D評分均顯著升高(P均0.05)。治療后2周、4周、8周和3個月時,A組患者VAS疼痛評分明顯低于B組的患者(P0.05),即A組疼痛緩解率(90%)明顯優(yōu)于B組的疼痛緩解率(P0.05)。治療后1周、2周、4周、8周和3個月,B組的患者生存質(zhì)量評分明顯低于A組生存質(zhì)量評分(P0.05)。結(jié)論連續(xù)硬膜外阻滯治療對年齡≤70歲的PHN患者的療效優(yōu)于年齡70歲的患者。
[Abstract]:Objective to compare the therapeutic effects of continuous epidural injection of lidocaine hydrochloride and glucocorticoid on patients with postherpetic neuralgia in different age groups. The lesions were located in the spinal innervation area of T3~T11. According to their age, the patients were divided into group A (n = 30) and group B (n = 30) and group B (n = 30). All patients were treated with epidural puncture and catheterization according to the corresponding spinal innervation segment of pain. Lidocaine hydrochloride and compound betamethasone were infused with analgesic pump 1 mL each for 1621 days. Visual analogue scores (VASs) were used to evaluate the quality of life (QOL) of pain intensity and EQ-5D at 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after treatment, and the results were compared with those before treatment. The VAS scores in both groups were significantly lower than those in group B at 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after treatment, and the scores of EQ-5D were significantly increased (P < 0.05). The VAS pain score of group A was significantly lower than that of group B at the end of 4 weeks and 8 weeks and 3 months after treatment, and it was significantly lower in group A than that in group B. The pain relief rate of group A was significantly better than that of group B (P 0.05). The scores of quality of life of patients in group B were significantly lower than those in group A at 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after treatment (P < 0.05). Conclusion continuous epidural block can be used in patients with continuous epidural block. The therapeutic effect on PHN patients 鈮，

本文編號：1670874