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目的:观察硬膜外用药及持续镇痛对带状疱疹患者主要症状的影响。方法:根据患者带状疱疹部位、疼痛范围和受累神经,选择相应的椎间隙行硬膜外腔穿刺置管,确认置管正确后,先注入消炎镇痛液(2%利多卡因3ml+地塞米松5mg+维生素B120.5mg+生理盐水至10ml),接PCEA泵,止痛液配方:罗哌卡因75mg+舒芬太尼20μg+曲马多500mg加生理盐水至100ml,背景流速2ml/h,PCA量1ml,锁定时间15min。观察30min～60min以VAS判定疼痛强度变化,无不适,交家属护送回家,观察记录疼痛强度变化、睡眠质量变化及副作用,并保持联系。结果:治疗前、治疗即刻和治疗后VAS评分差异有显著性。治疗前、治疗即刻和治疗后QS评分差异有显著性。结论:硬膜外用药及持续硬膜外镇痛能有效改善带状疱疹患者的主要症状。
Objective: To observe the effect of epidural medication and continuous analgesia on the main symptoms of patients with herpes zoster. Methods: According to the patient’s herpes zoster site, the pain range and the affected nerves, the corresponding intervertebral space was selected for epidural catheterization. After confirming the correct catheterization, anti-inflammatory analgesic solution (3% lidocaine 2% 5mg + Vitamin B120.5mg + normal saline to 10ml), then PCEA pump, analgesic formula: ropivacaine 75mg + sufentanil 20μg + tramadol 500mg plus normal saline to 100ml, background flow rate 2ml / h, PCA volume 1ml, Lock time 15min. Observed 30min ~ 60min to determine the VAS pain intensity changes, no discomfort, escorted families to go home, observe and record changes in pain intensity, quality of sleep changes and side effects, and maintain contact. Results: There were significant differences in VAS scores before treatment, immediately after treatment and after treatment. Before treatment, immediate treatment and post-treatment QS score difference was significant. Conclusion: Epidural administration and continuous epidural analgesia can effectively improve the main symptoms of patients with shingles.