【晨读】短时程外周神经电刺激治疗老年眼神经带状疱疹神经痛患者:回顾性研究(一）

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山东省立医院疼痛科英语晨读已经坚持10余年的时间了，每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯，二是可以学习前沿的疼痛相关知识。我们会将晨读内容与大家分享，助力疼痛学习。

本次文献选自Wan C,Song T.Short-Term Peripheral Nerve Stimulation Relieve Pain for Elder Herpes Zoster Ophthalmicus Patients:A Retrospective Study[J].Neuromodulation,2020;E-pub ahead of print.

ABSTRACT

Objective: Ophthalmic postherpetic neuralgia (PHN) is the final stage of herpes zoster (HZ) ophthalmicus and a severe refractory neuropathic pain, thus there is no curative treatment that could alleviate pain and reduce the incidence of ophthalmi PHN now. The purpose of this study is to evaluate therapeutic efficacy of short-term peripheral nerve stimulation (PNS) for elder patients with HZ ophthalmicus. Materials and Methods: We performed a retrospective study from March 2015 to August 2019 in our pain department. All the HZ ophthalmicus patients underwent supraorbital nerve short-term PNS were included. The patients’ data, including numeric rating scale (NRS), 36-Item short form health survey (SF-36), and analgesic consumptions, were retrospectively analyzed. Severe side effects also were recorded.

Results: A total of 68 patients were enrolled in this study. The NRS scores were significantly decreased at different time points after short-term PNS compared to baseline (p < 0.001). The SF-36 scores, including general health, social function, emotional role, mental health, bodily pain, physical functioning, physical role, and vitality, were significantly improved at different time point after treatment (p < 0.001). The average dosages of tramadol and pregabalin administered (mg/d) were both significantly reduced compared to baseline (p < 0.001). There was no bleeding, infection, pain increase, and other side effects after treatment.

Conclusions: Short-term PNS is an effective and safe therapeutic alternative for elder patients with HZ ophthalmicus and could reduce the incidence of ophthalmic PHN.

Keywords: 36-item Short Form health survey, herpes zoster ophthalmicus, neuropathic pain, numeric rating scale, peripheral nerve stimulation.

摘要

目的:眼神经带状疱疹后神经痛(PHN)是眼神经带状疱疹的终末期，是一种严重的复杂性神经病理性疼痛，目前尚无能有效缓解疼痛、降低发病率的治疗方法。本研究旨在探讨短时程外周神经刺激对老年眼神经带状疱疹患者的治疗效果。

材料和方法：我们将2015年3月至2019年8月在我院疼痛科的住院患者进行了回顾性研究。所有接受眶上神经短时程PNS治疗的眼神经带状疱疹患者均被包括在内。回顾性记录并分析患者数据，包括数字模拟量表(NRS)、36项健康调查简表(SF-36)和镇痛药使用情况，并记录严重的副作用。

结果:共有68例患者参与本研究。与基线相比，短期PNS后NRS评分在不同时间点显著下降(p < 0.001)。与基线相比，SF-36分包括一般健康、社会功能、情感角色、心理健康、身体疼痛、身体功能、身体角色、活力均显著降低(p < 0.001)。治疗后无出血、感染、疼痛加重等副作用发生。

结论:短时程PNS治疗老年眼神经带状疱疹是一种有效、安全的治疗方法，可降低眼部PHN的发生率。

关键词:36项健康调查简表、眼神经带状疱疹、神经病理性疼痛、数字模拟量表、周围神经电刺激。