老年带状疱疹36例神经性疼痛综合护理

目的:探讨老年带状疱疹患者神经性疼痛综合护理的方法.方法:对36例住院的老年带状疱疹患者进行综合护理,包括疼痛、心理、用药、皮肤护理及出院指导等方面.结果:36例患者皮损痊愈,生活质量明显提高,2周后出院.结论:合理有效的治疗配合恰当的综合护理,可以减轻神经痛,缩短病程,提高患者生活质量,是减少后遗神经痛的较佳方法.     

疼痛护理干预对带状疱疹后遗神经痛患者的影响

目的:探讨疼痛护理干预对带状疱疹后遗神经痛患者的影响。方法:将50例带状疱疹后遗神经痛患者随机分为观察组和对照组各25例,两组给予相同的治疗方法,对照组给予常规护理,观察组给予疼痛护理干预,比较两组临床疗效、疼痛程度、疼痛控制满意度、睡眠质量、护理满意度和生活质量。结果:观察组总有效率、疼痛控制满意度、睡眠质量、护理满意度和生活质量评分均高于对照组(P0.05);观察组疼痛评分低于对照组(P0.05)。结论:疼痛护理干预可明显改善带状疱疹后遗神经痛患者的疼痛程度和睡眠质量,提高患者护理满意度和生活质量。     

循经火疗配合中药外敷治疗带状疱疹后遗神经痛60例

带状疱疹后遗神经痛是带状疱疹皮损愈合后,受累区域出现疼痛或持续性疼痛3个月以上的一种慢性神经性疼痛综合征.有报道[1],62%的50岁以上的带状疱疹患者发生本病,对于中老年人患者,免疫力低下者临床治疗困难,严重影响患者的生活质量,临床治疗颇为棘手.2005年1月-2008年12月,笔者采用循经火疗法结合我院内自制中药外敷治疗带状疱疹后遗神经痛60例,疗效显著.     

三叉神经半月节阻滞与三叉神经干阻滞治疗急性带状疱疹性三叉神经痛的疗效对比

三叉神经是带状疱疹常见的受累部位,多数患者伴有头面部剧烈疼痛,严重影响患者的正常生活,并可延续成为疱疹后神经痛.为了最大限度地消除疼痛、减少带状疱疹后神经痛的发生,临床上及早控制疼痛尤为重要.我们对有重度疼痛的急性带状疱疹性三叉神经痛患者,进行了三叉神经半月节和三叉神经干阻滞的疗效对比,现报道如下.     

脉冲射频用于三叉神经疱疹后神经痛治疗的对比观察

目的:三叉神经带状疱疹后神经痛是头面部疼痛疾病中最有代表性的疾病之一,本文报道脉冲射频为主治疗三叉神经区疱疹后遗神经痛的效果.方法:本组共计疼痛科住院的三叉神经带状疱疹后神经痛患者30例,门诊患者30例,观察药物及脉冲射频治疗前、后疼痛程度和性质、患区遗留症状和睡眠质量.结果:患者主诉头面部自发性闪电样疼痛、刀割样疼痛、烧灼样疼痛为主.激惹型42例,麻痹型18例,平均VAS评分为8.2分.药物组患者治疗后平均VAS评分为5.4分.经过加用2次脉冲射频治疗(2Hz,40℃,120s)平均VAS评分为3.3分.经过14-18个月的随访,脉冲射频组疗效稳定.结论:本组三叉神经疱疹后神经痛患者结果表明:加用脉冲射频治疗后大部分患者疼痛缓解明显,效果比较稳定,患者的生活质量明显改善.     

疼痛护理干预应用于带状疱疹后神经痛的效果评价

<正>带状疱疹后神经痛泛指在带状疱疹消退后存在的局部剧烈疼痛,患者多无法睡眠,严重影响日常休息与生活质量[1]。研究[2]指出,护理干预是有效提高镇痛疗效的方案之一,但其在带状疱疹后神经痛治疗领域却处于初级阶段。本研究探讨疼痛护理干预在带状疱疹后神经痛患者治疗期间     

硬膜外置管按需注药治疗带状疱疹后遗神经痛的效果及护理

总结了硬膜外置管并按需注药治疗带状疱疹后遗神经痛的护理经验,包括对本院疼痛科收治的62例非头面部带状疱疹后遗神经痛患者,通过硬膜外置管按需注药进行治疗,并给予生活护理、心理护理、健康教育和疼痛护理。认为硬膜外置管并按需注药治疗带状疱疹后遗神经痛,同时进行针对性护理,可以明显减轻患者疼痛,提高生活质量。     

团队式疼痛共控法对顽固性带状疱疹后遗神经痛患者的影响分析

目的观察团队式疼痛共控法对顽固性带状疱疹后遗神经痛患者的影响效果。方法选择2020年7月至2021年6月收治于盐城市大丰人民医院的带状疱疹顽固性后遗神经痛患者86例为研究对象，其中2020年7月至12月收治的43例为对照组，2021年1月至6月收治的43例为观察组，对照组予以常规护理，观察组接受团队式疼痛共控法干预，比较两组干预后的疼痛评分、焦虑抑郁评分、生活质量影响度评分。结果干预后观察组疼痛评分、焦虑抑郁评分、生活质量影响度评分均低于对照组（均P＜0.05）。结论采用团队式疼痛共控法对顽固性带状疱疹后遗神经痛患者施加干预，可显著提高疼痛管理效果，改善患者负面情绪与生活质量。     

全方位护理对老年带状疱疹后遗神经痛患者疼痛和生活质量的影响

目的:探讨全方位护理对老年带状疱疹后遗神经痛患者疼痛和生活质量的影响。方法:选择我院2016年1~12月带状疱疹后遗神经痛患者86例随机等分为研究组和对照组,对照组采用常规护理,研究组在对照组基础上加用全方位护理,比较两组患者生活质量的改善情况。结果:研究组疼痛VAS评分、SF36生活质量表PCS评分和MCS评分及满意情况均明显高于对照组,差异有统计学意义(P0.05)。结论:对带状疱疹后遗神经痛患者在常规护理基础上给予疼痛护理,不仅能够有效缓解患者的疼痛感觉,而且还能改善其生活质量,促进预后康复,值得推广。     

带状疱疹后神经痛临床调查分析

目的:带状疱疹后神经痛是周围神经受到病毒损伤后的疼痛疾病中最有代表性的疾病之一,本文报道疼痛科集中6年来调查、统计的临床病例结果.方法:2004年起使用神经痛表共统计门诊、住院及会诊的带状疱疹后神经痛患686例,主要观察疼痛程度和性质、临床类型、患区遗留症状和伴随症状.结果:患者主诉以自发性闪电样疼痛、刀割样疼痛、烧灼样疼痛、针刺样疼痛和混合性疼痛为多见.平均VAS评分为6.8分.患者临床表现为4种类型的变化,分别为激惹型(57.14%)、麻痹型(22.16%)、整合型(17.93%)和无激惹型(2.77%).结论:本组疱疹后神经痛患者调查表明:大部分患者疼痛时间均超过3-6个月,最长达8年.疼痛程度为中、重度.患者的生活质量、工作能力均明显受影响.     

带状疱疹后遗神经痛相关因素的分析及护理

目的研究影响带状疱疹后遗神经痛疼痛(postherpetic neuralgia,PHN)程度的相关因素,提出相应的护理对策。方法对82例带状疱疹后遗神经痛患者进行视觉模拟评分(visual analog scale,VAS)评估,并记录患者的年龄、性别、PHN急性期疼痛的发作频率、疼痛的性质、疱疹部位,分析这些因素与经痛程度的相关性,提出相应的护理对策。结果PHN疼痛程度与性别显著相关(P<0.05),而与年龄、疼痛发作频率、疼痛的性质、疱疹部位无显著相关。患者急性期发作频度以持续性疼痛(78.0%)居多,疼痛性质以烧灼样(39.0%)和针刺样(28.0%)为主。结论对PHN患者应重视疼痛的护理评估和健康教育,尤其是对老年男性持续性烧灼样和针刺样疼痛的患者,应积极实施心理护理;教会患者缓解疼痛的方式,以减轻疼痛提高患者的生活质量。     

脉冲射频刺激联合普瑞巴林治疗带状疱疹后遗三叉神经痛的临床效果

目的 探讨脉冲射频刺激联合普瑞巴林治疗带状疱疹后遗三叉神经痛的临床效果,为临床治疗该病提供参考依据.方法 选取我科室于2017年2月至2020年2月收治的358例带状疱疹后遗三叉神经疼痛者为研究对象,以随机数字表法将其分为对照组和观察组,各179例.对照组给予普瑞巴林治疗,观察组给予脉冲射频刺激联合普瑞巴林治疗.比较两...     

疼痛护理干预对带状疱疹后遗神经痛患者视觉模拟评分及睡眠质量的影响

目的:分析疼痛护理干预在带状疱疹后遗神经痛治疗中的应用效果及对患者疼痛程度和睡眠质量的影响。方法:选取2019年1月至2019年12月来安徽省蚌埠市第一人民医院接受带状疱疹后遗神经痛治疗的患者60例作为研究对象,随机分为观察组和对照组,每组30例。对照组患者接受护理,观察组患者接受疼痛护理干预,比较2组患者护理前后疼痛程度、睡眠质量、生命质量和护理满意率。结果:护理后观察组患者VAS评分和PSQI评分均明显低于对照组,SF-36评分明显高于对照组(P<0.05);观察组护理满意率为93.33%,对照组为80.00%,P<0.05。结论:疼痛护理干预可有效改善带状疱疹后遗神经痛患者的疼痛程度,对于提高患者的睡眠质量和护理满意率效果显著,值得推广应用。     

Herpes zoster in older adults. (Duke University Medical Center, Durham, NC) Clinical Infectious Diseases. 2001;32:1481–1486.

Herpes zoster (HZ) strikes millions of older adults annually worldwide and disables a substantial number of them via postherpetic neuralgia (PHN). Key aged‐related clinical, epidemiological, and treatment features of zoster and PHN are reviewed in this article. HZ is caused by renewed replication and spread of the varicella‐zoster virus (VZV) in sensory ganglia and afferent peripheral nerves in the setting of age‐related, disease‐related, and drug‐related decline in cellular immunity to VZV. VZV‐induced neuronal destruction and inflammation causes the principal problems of pain, interference with activities in daily living, and reduced quality of life in elderly patients. Recently, attempts to reduce or eliminate HZ pain have been bolstered by the findings of clinical trials that antiviral agents and corticosteroids are effective treatment for HZ and that tricyclic antidepressants, topical lidocaine, gabapentin, and opiates are effective treatment for PHN. Although these advances have helped, PHN remains a difficult condition to prevent and treat in many elderly patients. Comment by Miles Day, M.D. This article reviews the epidemiology clinical features diagnosis and treatment of acute herpes zoster. It also describes the treatment of postherpetic neuralgia. While this is a good review for the primary care physician, the discussion for the treatment for both acute herpes zoster and postherpetic neuralgia do not mention invasive therapy. It is well documented in pain literature that sympathetic blocks with local anesthetic and steroid as well as subcutaneous infiltration of active zoster lesions not only facilitate the healing of acute herpes zoster but also prevents or helps decrease the incidence of postherpetic neuralgia. All patients who present to the primary care physician with acute herpes zoster should have an immediate referral to a pain management physician for invasive therapy. The treatment of postherpetic neuralgia is a challenging experience both for the patient and the physician. While the treatments that have been discussed in this article are important, other treatments are also available. Regional nerve blocks including intercostal nerve blocks, root sleeve injections, and sympathetic blocks have been used in the past to treat postherpetic neuralgia. If these blocks are helpful, one can proceed with doing crynourlysis of the affected nerves or also radio‐frequency lesioning. Spinal cord stimulation has also been used for those patients who are refractory to noninvasive and invasive therapy. While intrathecal methylprednisolone was shown to be effective in the study quoted in this article one must be cautious not to do multiple intrathecal steroid injections in these patients. Multilple intrathecal steroid injections can lead to archnoiditis secondary to the accumulation of the steroid on the nerve roots and in turn causing worsening pain.     

Postzosterneuralgie

Postherpetic neuralgia is considered to be a neuropathic pain syndrome. Typically, patients experience pain in the dermatomes of skin lesions persisting for more than 3 months after skin restitution. About 10?% of patients with herpes zoster develop postherpetic neuralgia. Its prevalence increases with age. Common clinical symptoms include continuous burning pain, sharp pain attacks, and allodynia. Additionally, sensory hyperactivation or loss in the affected skin area is present. Pathophysiology includes mechanisms of peripheral and central sensitization, based on damaged nerve fibers as the main mechanisms for pain generation and its maintenance. Clinical studies did show pain relief in postherpetic neuralgia after administration of antidepressants, antiepileptic drugs, opioids, and topical capsaicin and lidocaine. Nevertheless, about one third of patients do not respond to conventional treatment. Given the fact that postherpetic neuralgia is considered to be a chronic pain disease, a multidisciplinary treatment approach is necessary.     

阿片类药物在慢性非癌性疼痛中的应用

目的:回顾性分析卡马西平和加巴喷丁治疗原发性三叉神经痛、带状疱疹以及带状疱疹后遗神经痛的疗效、安全性和不良反应。方法:102位患者进入本研究,比较卡马西平或加巴喷丁治疗前后患者疼痛强度的改变和对睡眠影响的改善;依据药物分类,比较两种药物的副作用和不良反应。结果:卡马西平治疗原发性三叉神经痛起效较加巴喷丁快,二者长期疗效相当;加巴喷丁治疗带状疱疹和带状疱疹后神经痛的疗效优于卡马西平;疗效随治疗时间的延长而增加。卡马西平的副作用和不良反应事件发生率较加巴喷丁高。结论:抗癫痫药物卡马西平和加巴喷丁是治疗神经病理性疼痛的有效药物,可以改善患者的睡眠,但副作用和不良反应发生率高。     

Desipramine relieves postherpetic neuralgia

Desipramine has the least anticholinergic and sedative effects of the first generation tricyclic antidepressant agents, but its pain-relieving potential has received little study. Other antidepressant agents--notably amitriptyline--are known to ameliorate postherpetic neuralgia, but those agents are often toxic. In a randomized double-blind crossover design, we gave 26 postherpetic neuralgia patients 6 weeks of treatment with desipramine (mean dose, 167 mg/day) and placebo. Nineteen patients completed both treatments; 12 reported at least moderate relief with desipramine and two reported relief with placebo. Pain relief with desipramine was statistically significant from weeks 3 to 6. Psychiatric interview at entry into the study produced a diagnosis of depression for 4 patients; pain relief was similar in depressed and nondepressed patients and was statistically significant in the nondepressed group alone. We conclude that desipramine administration relieves postherpetic neuralgia and that pain relief is not mediated by mood elevation. Blockade of norepinephrine reuptake, an action shared by desipramine, amitriptyline, and other antidepressant agents that have relieved neuropathic pain, may be involved in relief of postherpetic neuralgia.     

Pain treatment of herpes zoster

Reactivation of varicella-zoster virus causes herpes zoster, which accompanies severe pain in most patients. Treatment of pain is mandatory in herpes zoster. Pain caused by herpes zoster is classified as acute herpetic pain and postherpetic neuralgia. The mechanisms and treatments for the two pains are different. Acute herpetic pain is inflammatory and nociceptive one. Treatment for acute herpetic pain includes antiviral drugs, non-steroidal anti-inflammatory drugs, opioids, and sympathetic nerve blockade. Postherpetic neuralgia is a neuropathic pain and requires antidepressants, anticonvulsants, and anti-arrhythmic drugs to relieve the pain. Topical application of capsaicin and local anesthetics may benefit some patients with postherpetic neuralgia.     

Herpes Zoster Pain,Postherpetic Neuralgia,and Quality of Life in the Elderly

Herpes zoster pain and postherpetic neuralgia (PHN) particularly affect older persons. This literature review presents how quality of life is evaluated and the consequences of shingles and PHN on the quality of life of older persons. Although more than 150 articles have been published on herpes zoster and its consequences, specific studies focusing on the older population are needed, in several domains like epidemiology, preventive medicine, neuropsychology, and pharmacology.     

Therapy and prophylaxis of facial neuralgias and other forms of facial pain syndromes -- revised recommendations of the German Society of Migraine and Headache

Trigeminal neuralgia and postherpetic neuralgia are the most relevant neuralgiform facial pain syndromes. Trigeminal neuralgia is characterized by lancinating intensive pain attacks of very short duration, triggered by external cues,whereas postherpetic neuralgia consists predominantly of long-lasting burning pain. Sodium channel blocking drugs are first choice in treatment of trigeminal neuralgia, operative procedures encompass microvascular decompression,thermocoagulation and percutaneous retrogasserian glycerol rhizotomy. In the acute stage postherpetic neuralgia is treated antivirally and analgesically, in the chronic stage by tricyclic antidepressive substances. Other pain syndromes described encompass the Tolosa-Hunt-syndrome, cervicogenic headache, craniomandibular dysfunction syndrome, atypical facial pain and rarer syndromes. Therapeutic recommendations are based on evidence based medicine criteria (EBM).