CT引导下脊髓射频热凝术治疗脊髓损伤性神经病理性疼痛

doi:10.3969/j.issn.1006-7795.2014.01.005

摘要/Abstract

摘要：

目的评价CT引导下脊髓射频热凝术（spinal cord radiofrequency thermocoagulation，SCRT）治疗脊髓损伤继发性神经病理性疼痛的有效性和安全性；探讨SCRT的适应证和禁忌证。方法根据预设的纳入和排除标准，入组43例完全性脊髓损伤继发性神经病理性疼痛患者，并进行CT引导下SCRT。手术前后分别采用视觉模拟评分（visual analogue scale，VAS）及其加权值（VAS weighted value，VAS-WV），以及简式McGill疼痛问卷（simplified form of McGill pain questionnaire，SF-MPQ）评价镇痛疗效，术后3、6、12、24和36个月分别进行VAS和合并症随访。结果术后VAS、疼痛分级指数总分（PRI-T）、疼痛强度（PPI）显著降低；VAS-WV显示术后疼痛缓解率为97.7%；术后3、6、12、24和36个月随访期的疼痛缓解率分别为97.7%、97.5%、94.3%、92.9%和90.5%；合并症包括硬膜刺破后头痛（18.6%）和腹痛（11.6%），均于术后7日内完全缓解；术后36个月随访期内未发现远期合并症。结论 CT引导下SCRT是脊髓损伤继发性神经病理性疼痛安全、有效的微创介入手术方法。

关键词: 脊髓损伤, 神经病理性疼痛, 射频

Abstract:

Objective To evaluate the efficacy and safety of computed tomography-guided spinal cord radiofrequency thermocoagulation (SCRT) in treating neuropathic pain following spinal cord injury (NeP following SCI) and to investigate indications and contraindications of SCRT. Methods According to the preset inclusive and exclusive criteria, 43 patients with NeP following SCI accepted CT-guided SCRT. Visual analogue scale (VAS), VAS weighted value (VAS-WV) and simplified form of McGill Pain Questionnaire (SF-MPQ) were used to evaluate before and after SCRT; VAS and complications were followed up for 3, 6, 12, 24 and 36 months after SCRT respectively.Results VAS, total pain rating index (PRI-T) and present pain intensity (PPI) were significantly decreased after SCRT; postoperative relief rate was 97.7%; in follow-up period, relief rate was 97.7%, 97.5%, 94.3%, 92.9% and 90.5%, respectively; postoperative complications were post-dural puncture headache (18.6%) and stomachache (11.6%), all complications were completely relieved within 7 days after SCRT; no long-term complication was reported in follow-up period. Conclusion SCRT was effective and safe in treating NeP following SCI.

Key words: spinal cord injury, neuropathic pain, radiofrequency

中图分类号:

R441.1

王琦, 倪家骧. CT引导下脊髓射频热凝术治疗脊髓损伤性神经病理性疼痛[J]. 首都医科大学学报, 2014, 35(1): 18-22.

Wang Qi, Ni Jiaxiang. Computed tomography-guided spinal cord radiofrequency thermocoagulation for neuropathic pain following spinal cord injury[J]. Journal of Capital Medical University, 2014, 35(1): 18-22.

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