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CT 引导下选择性背根节射频热凝治疗非相邻节段带状疱疹后神经痛 1 例报告

潘 瑞, 张 广建

摘要

目的:探究影像引导下多节段神经射频热凝术对非连续节段(non-contiguous segments)分布难治性带状疱疹后神经痛(PHN)的疗效。方法:针对1例77岁女性非相邻节段(T7-T9)PHN 患者,采用CT三维导航下左侧T8/9、T9/10背根节射频热凝。评估术前术后视觉模拟评分(VAS),结合神经电生理与解剖学研究分析疗效机制。结果:术后1周患者VAS评分从6分降至3分,疼痛缓解率达50%,FIM评分由45分(重度依赖)提升至62分(中度依赖);随访3个月VAS稳定于2-3分,FIM维持65分,无运动障碍或感染并发症。结论:CT 引导下多靶点神经毁损可有效干预非相邻节段PHN,其机制与精准阻断痛觉传导通路、调控炎性微环境相关,为老年难治性病例提供新思路。长期疗效需扩大样本验证。

关键词

带状疱疹后神经痛;CT 三维导航;射频热凝;非连续节段

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参考

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