两种不同电压脉冲射频治疗老年带状疱疹后神经痛的疗效比较

Comparison of two different voltage pulsed radiofrequency for treatment of postherpetic neuralgia in the elderly

关键词:  带状疱疹后神经痛  电压  脉冲射频  背根神经节  老年

Key words:  postherpetic neuralgia  voltage  pulsed radiofrequency  dorsal root ganglion  elderly

摘要:

目的　分析CT引导下两种不同电压(45 V、65 V)脉冲射频(pulsed radiofrequency，PRF)治疗老年带状疱疹后神经痛(postherpetic neuralgia，PHN)的疗效和安全性。方法　选择老年胸背部PHN患者60例，根据使用的PRF电压不同分为两组：A组(45 V)和B组(65 V) ，每组30例。所有患者均以胸神经背根神经节(dorsal root ganglion，DRG)为靶点进行PRF治疗。采用视觉模拟评分(visual analogue scale，VAS)评估两组治疗前和治疗后1周、1个月、3个月的疼痛程度，采用匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)对两组治疗前和治疗后1个月、3个月的睡眠质量进行评估,记录两组治疗前后的普瑞巴林口服剂量。结果　两组患者术后各时间点的VAS、PSQI、普瑞巴林剂量均较治疗前改善(P<0.05)。在同一时间点的随访中，B组患者的VAS、PSQI和普瑞巴林剂量均明显低于A组(P<0.05)。结论　与45 V相比，65 V的PFR治疗PHN疗效更好。

Abstract:

Objective　To compare the efficacy and safety of pulsed radiofrequency (PRF) under two different voltages (45 V and 65 V) guided by CT in the treatment for postherpetic neuralgia (PHN) in the elderly. 　Methods　Totally, 60 elderly patients with chest and back PHN were selected. According to the PRF voltage used, the patients were divided into two groups: group A (45 V, n＝30) and group B (65 V, n＝30). All patients were treated with PRF targeting dorsal root ganglion (DRG) of thoracic nerve. Visual analogue score (VAS) was used to evaluate the pain degree of the two groups before treatment and 1 week, 1 month and 3 months after treatment, and Pittsburgh Sleep Quality index (PSQI) was used to evaluate the sleep quality of the two groups before treatment and 1 month，3 months after treatment. The pregabalin doses were recorded before and after treatment in both groups. 　Results　The VAS, PSQI and pregabalin doses of the two groups at each time point after treatment were improved compared with those before treatment （P<0.05). At the 1 week, 1 month, and 3 months follow-ups, patients in group B had significantly better pain relief, sleep quality improvements, and pregabalin doses reduction than group A （P<0.05). 　Conclusion　Compared with 45 V, 65 V PFR is more effective in the treatment of PHN.