| 张华,王波,何杰,周洁.超声引导下不同平面阻滞方法对胸段急性带状疱疹性神经痛的疗效观察*[J].浙江中西医结合杂志,2020,30(12): |
| 超声引导下不同平面阻滞方法对胸段急性带状疱疹性神经痛的疗效观察* |
| The effect of different ultrasound-guided plane block methods for thoracic herpetic neuralgiaZHANG Hua,WANG Bo,HE Jie,ZHOU Jie. Department of Anesthesiology and Pain Management, The Third People"s Hospital of Hangzhou,Hangzhou,Zhejiang,310009,China |
| 投稿时间：2020-07-26 修订日期：2020-10-20 |
| DOI： |
| 中文关键词: 带状疱疹 神经痛 超声检查 神经传导阻滞 |
| 英文关键词:herpes zoster neuralgia risk factor Ultrasonography Nerve block |
| 基金项目:浙江省杭州市社会发展科研自主申报项目(20180533B61) |
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| 中文摘要: |
| 目的 分析超声引导下竖脊肌平面阻滞和前锯肌平面阻滞联合普瑞巴林对胸段带状疱疹性神经痛的临床疗效。方法 选择胸段带状疱疹性神经痛患者89例,按照随机数字表法分为三组：C组采用口服普瑞巴林进行治疗(n=32)；E组采用超声引导下竖脊肌平面阻滞联合口服普瑞巴林治疗(n=28)；S组采用超声引导下前锯肌平面阻滞联合口服普瑞巴林治疗(n=29)。观察记录三组患者治疗前及治疗后1、2、4、8周的视觉模拟评分(VAS)分、睡眠质量评分(QS)、普瑞巴林总用量以及治疗期间发生的相关不良反应。结果 组内比较：三组患者治疗后的第1、2、4、8周VAS评分和QS评分较治疗前均显著降低(P <0.05)；组间比较：第1、2、4、8周E组和S组VAS评分和QS评分较C组显著降低(P <0.05),第1、2、4、8周S组VAS评分和QS评分低于E组(P <0.05)；三组患者中C组口服普瑞巴林的总量要明显高于其他两组(P <0.05),其中E组的用量要高于S组(P <0.05)；C组治疗的总有效率为43.75%,E组的总有效率为71.43%,S组的总有效率为93.10%。结论 超声引导下竖脊肌平面阻滞和前锯肌平面阻滞可以有效缓解胸段带状疱疹患者的疼痛,改善患者睡眠质量,明显减少口服药物的用量；前锯肌平面阻滞的疗效要优于竖脊肌平面阻滞。 |
| 英文摘要: |
| Objective To analyze the clinical effect of ultrasound-guided erector spinae plane block(ESPB) and serratus anterior plane block(SAPB) combined with pregabalin on thoracic herpetic neuralgia. Methods 89 patients with thoracic herpetic neuralgia were divided into three groups according to the random number table: Group C was treated with oral pregabalin (n=32); Group E was treated with ESPB combined with oral pregabalin under the guidance of ultrasound (n=28); Group S was treated with SAPB combined with oral pregabalin under the guidance of ultrasound (n=29). The visual analogue score (VAS), sleep quality score (QS), the total dosage of pregabalin and the related adverse reactions during the treatment were observed and recorded. Results Comparison within groups: the VAS score and QS score of the 1, 2, 4, 8 weeks after treatment in the three groups were significantly lower than those before treatment (P < 0.05); Comparison between groups: the VAS score and QS score of the 1, 2, 4, 8 weeks in Group E and group S were significantly lower than those in group C (P < 0.05), and the VAS score and QS score of the 1, 2, 4, 8 weeks in group S were lower than those in Group E(P < 0.05). Among the three groups, the total amount of oral pregabalin in group C was significantly higher than that in the other two groups (P < 0.05), and the amount of oral pregabalin in Group E was higher than that in group S (P < 0.05); the total effective rate in group C was 43.75%, that in Group E was 71.43%, and that in group S was 93.10%. Conclusion ultrasound-guided ESPB and SAPB combined with pregabalin can effectively relieve the pain of patients with thoracic herpetic neuralgia, significantly reduce the dosage of oral medicine, and improve the sleep quality of patients; the effect of SAPB is better than that of ESPB. |
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