| 摘要: |
| ［摘要］ 目的 观察脉冲射频（PRF）联合静脉滴注利多卡因治疗急性带状疱疹性神经痛（AHN）的效果。方法 招募2023年4月至2024年6月皖南医学院附属合肥市第二人民医院介入血管疼痛科收治的AHN患者60例。采用随机数字表法将其分为观察组和对照组，各30例。观察组接受PRF联合静脉滴注利多卡因（1次/d，共7 d），对照组接受PRF联合静脉滴注生理盐水治疗。予患者口服曲马多缓释片，100 mg/次，1次/12 h；如患者疼痛降低为轻度，则改为50 mg/次，1次/12 h；当视觉模拟量表(VAS)评分<3分则停止用药。比较两组入院时（T0）、术后3 d（T1）、术后1周（T2）、术后1个月（T3）及术后3个月（T4）的VAS评分、医院焦虑和抑郁量表（HADS）评分［包括医院焦虑量表（HA）评分和医院抑郁量表（HD）评分］及匹兹堡睡眠质量指数（PSQI）评分。比较两组住院期间（T0～T2）曲马多用量，术后不良反应及带状疱疹后遗神经痛（PHN）发生情况。结果 两组术后VAS评分、PSQI评分均呈下降趋势（P<0.05）。观察组T3、T4时间点VAS评分显著低于对照组（P<0.05），T1、T2、T3、T4时间点PSQI评分显著低于对照组（P<0.05）。两组术后HA评分、HD评分均呈下降趋势（P<0.05），但两组各时间点评分比较差异无统计学意义（P>0.05）。观察组住院期间曲马多用量显著少于对照组（P<0.05）。两组T3时间点PHN累积发生率比较差异无统计学意义（P>0.05）。观察组T4时间点PHN累积发生率显著低于对照组（P<0.05）。观察组不良反应总发生率高于对照组，但差异无统计学意义（26.67% vs 10.00%； χ2=2.783，P=0.095）。结论 PRF联合静脉滴注利多卡因治疗AHN安全有效，并可降低PHN发生风险。 |
| 关键词: 急性带状疱疹性神经痛 带状疱疹后遗神经痛 脉冲射频 利多卡因 |
| DOI：10.3969/j.issn.1674-3806.2025.05.14 |
| 分类号:R 751 |
| 基金项目:安徽医科大学校科研基金项目（编号：2023xkj228） |
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| Observation on effect of pulsed radiofrequency combined with intravenous drip of lidocaine in treatment of acute herpetic neuralgia |
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CHANG Xindong1,2, TANG Ming1, WANG Yiwen1, QIAN Chenhuiyu3, PAN Shengquan1, YIN Shiwu1
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1.Department of Interventional Vascular Pain Management, the Second People′s Hospital of Hefei Affiliated to Wannan Medical College, Hefei 230000, China; 2.Graduate School, Wannan Medical College, Wuhu 241002, China; 3.Echocardiography Room, Hefei First People′s Hospital, Hefei 230000, China
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| Abstract: |
| ［Abstract］ Objective To observe the effect of pulsed radiofrequency(PRF) combined with intravenous drip of lidocaine in treatment of acute herpetic neuralgia(AHN). Methods A total of 60 patients with AHN who were admitted to Department of Interventional Vascular Pain Management, the Second People′s Hospital of Hefei Affiliated to Wannan Medical College from April 2023 to June 2024 were recruited. The patients were divided into observation group and control group by using random number table method, with 30 cases in each group. The observation group received PRF combined with intravenous drip of lidocaine(once a day for 7 days), while the control group received PRF combined with intravenous drip of normal saline treatment. The patients were given tramadol sustained-release tablets orally, 100 mg each time, once every 12 hours. If the patients′ pain levels were reduced to mild pain, the dose of oral tramadol sustained-release tablets was changed to 50 mg each time, once every 12 hours. When the patients′ Visual Analogue Scale(VAS) scores were less than 3 points, the oral tramadol sustained-release tablets were discontinued. The VAS scores, Hospital Anxiety and Depression Scale(HADS) scores［including Hospital Anxiety Scale(HA) scores and Hospital Depression Scale(HD) scores］ and Pittsburgh Sleep Quality Index(PSQI) scores were compared between the two groups at admission(T0), 3 days after surgery(T1), 1 week after surgery(T2), 1 month after surgery(T3) and 3 months after surgery(T4). The dosage of tramadol during hospitalization(T0-T2 time points), postoperative adverse reactions and the occurrence of post-herpetic neuralgia(PHN) were compared between the two groups. Results The postoperative VAS scores and PSQI scores showed a downward trend in the two groups(P<0.05). The VAS scores of the observation group were significantly lower than those of the control group at the time points of T3 and T4(P<0.05), and the PSQI scores of the observation group were lower than those of the control group at the time points of T1, T2, T3 and T4(P<0.05). The HA scores and HD scores showed a downward trend in the two groups(P<0.05), but there were no significant differences in the HA scores and HD scores between the two groups at each time point(P>0.05). The dosage of tramadol in the observation group was significantly lower than that in the control group during hospitalization(P<0.05). There was no significant difference in the cumulative incidence of PHN between the two groups at the time point of T3(P>0.05), while the cumulative incidence of PHN in the observation group was significantly lower than that in the control group at the time point of T4(P<0.05). The total incidence of adverse reactions in the observation group was higher than that in the control group, but the difference was not statistically significant(26.67% vs 10.00%; χ2=2.783, P=0.095). Conclusion PRF combined with intravenous drip of lidocaine is safe and effective in treatment of AHN, and can reduce the risk for the occurrence of PHN. |
| Key words: Acute herpetic neuralgia(AHN) Post-herpetic neuralgia(PHN) Pulsed radiofrequency(PRF) Lidocaine |
