CAJ | 학술논문

目的评价硬膜外自控镇痛联合更昔洛韦治疗患者带状疱疹神经痛的效果.方法带状疱疹神经痛患者60例,年龄51 ～ 86岁,ASA分级Ⅰ-Ⅲ级,采用随机数字表法分为2组(n=30):更昔洛韦组(F组)和硬膜外自控镇痛联合更昔洛韦组(FB组).FB组和F组静脉滴注更昔洛韦0.25 g,2次/d,连续滴注7d,FB组同时采用自控镇痛泵进行持续硬膜外镇痛(配方:罗哌卡因300 mg+氢化泼尼松龙20 mg+地佐辛10 mg+生理盐水至250 ml).于患者治疗前1 d(T0)和治疗后7 d(T1)、1个月(T2)和6个月(T3)时记录视觉模拟评分(VAS评分)、生存质量评分(QOL评分)和T1-3时疼痛缓解情况.结果与T0时比较,两组患者T13时VAS和QOL评分降低(P＜0.05);与F组比较,FB组T13时VAS评分降低,QOL评分和疼痛缓解率升高(P＜0.05).结论硬膜外自控镇痛联合更昔洛韦可有效缓解带状疱疹神经痛.
목적 평개경막외자공진통연합경석락위치료환자대상포진신경통적효과.방법 대상포진신경통환자60례,년령51 ～ 86세,ASA분급Ⅰ-Ⅲ급,채용수궤수자표법분위2조(n=30):경석락위조(F조)화경막외자공진통연합경석락위조(FB조).FB조화F조정맥적주경석락위0.25 g,2차/d,련속적주7d,FB조동시채용자공진통빙진행지속경막외진통(배방:라고잡인300 mg+경화발니송룡20 mg+지좌신10 mg+생리염수지250 ml).우환자치료전1 d(T0)화치료후7 d(T1)、1개월(T2)화6개월(T3)시기록시각모의평분(VAS평분)、생존질량평분(QOL평분)화T1-3시동통완해정황.결과 여T0시비교,량조환자T13시VAS화QOL평분강저(P＜0.05);여F조비교,FB조T13시VAS평분강저,QOL평분화동통완해솔승고(P＜0.05).결론 경막외자공진통연합경석락위가유효완해대상포진신경통.
Objective To evalvate the efficacy of patient-controlled epidural analgesia (PCEA) combined with ganciclovir for treatment of postherpetic neuralgia in patients.Methods A total of 60 patients with PHN,aged 51-86 yr,of ASA physical status Ⅰ-Ⅲ,were randomly assigned into 2 groups (n =30 each) using a random number table:ganciclovir group (F group) and PCEA combined with ganciclovir group (FB group).In FB and F groups,ganciclovir 0.25 g was infused intravenously twice a day for 7 consecutive days.In addition,continuous PCEA was performed simultaneously in group FB and the PCEA solution contained ropivacaine 300 mg,prednisolone 20 mg and dezocine 10 mg in 250 ml of normal saline.At 1 day before treatment (T0) and 7 days,1 month,and 6 months after treatment (T1-3),pain was assessed with visual analogue scale (VAS),and the quality of life (QOL) score and pair relief rate were recorded.Results VAS and QOL scores were significantly lower at T1-3 than at T0 in the two groups.Compared with F group,VAS scores were significantly decreased,and QOL score and pain relief rate were increased at T1-3 in FB group.Conclusion PCEA combined with ganciclovir can effectively alleviate postherpetic neuralgia in the patients.