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目的观察神经刺激器定位椎旁神经根乙醇毁损治疗带状疱疹后神经痛(PHN)的临床效果。方法选择带状疱疹所累及脊神经的椎间隙,在神经刺激器引导下行椎旁神经根穿刺定位,注入1%利多卡因5 ml,如疼痛缓解程度超过50%,观察30 min后,给予95%乙醇2 ml,患者保持治疗时的体位2 h,然后坐位观察1 h后离院。3 d后复诊,如有必要可以再次重复上述治疗。每次治疗前后测定患者的VAS值以及自发疼痛范围的面积.同时记录可能出现的不良反应。结果共有18例患者接受了椎旁神经根乙醇毁损治疗,VAS评分由治疗前的(8.62±1.21)降为(2.58±1.37)(P<0.01),自发性疼痛面积也由治疗前的(1.0±0.00)减为(0.56±0.23)(P<0.01)。结论门诊PHN患者采取神经刺激器定位椎旁神经根乙醇毁损治疗是一种安全有效的治疗方法。
Objective To observe the clinical effect of neurostimulator positioning paravertebral nerve root ethanol injury on post-herpetic neuralgia (PHN). Methods Select the intervertebral space of the spinal nerve involved in herpes zoster. Under the guidance of neurostimulator, paravertebral nerve root puncture was performed. 5 ml of 1% lidocaine was infused. If the degree of pain relief was over 50%, the rate of 95% Ethanol 2 ml, the patient kept the position of treatment 2 h, then sit 1 h after observation and leave the hospital. 3 d after the referral, if necessary, repeat the above treatment again. The VAS value of patients and the area of spontaneous pain were measured before and after each treatment, and the possible adverse reactions were recorded. Results A total of 18 patients underwent paravertebral nerve root ethanol injury. The VAS score decreased from (8.62 ± 1.21) to (2.58 ± 1.37) before treatment (P <0.01) and spontaneous pain area decreased from 1.0 ± 0.00) to (0.56 ± 0.23) (P <0.01). Conclusion It is a safe and effective treatment for out-patient PHN patients to adopt neurostimulator to locate the paravertebral nerve root ethanol damage.