硬膜外腔置管注药治疗带状疱疹后遗神经痛护理.docVIP

硬膜外腔置管注药治疗带状疱疹后遗神经痛护理作者单位：510260 广州医学院第二附属医院 通讯作者：周奕红 【摘要】 目的 探索硬膜外腔置管后注药治疗带状疱疹后遗神经痛患者的护理要点。方法 中重度带状疱疹后遗神经痛患者23例，采用硬膜外腔置管注药2周，观察患者置管前后体位配合、置管后导管的护理、并发症处理，术后1周及2周VAS评分，术后随访3～6月。结果 治疗后经专科护理1周，带状疱疹后遗神经痛患者疼痛程度明显减轻，治疗后1周VAS评分由6～7分下降至3～4分，2周后对疼痛进行VAS评分由3～4分下降至1～2分。结论 常规保护神经用药配合硬膜外腔置管注药治疗带状疱疹后遗神经痛患者，结合疼痛科的专科护理，达到保护神经、缓解疼痛的目的。 【关键词】 硬膜外腔置管注药; 带状疱疹后遗神经痛; 护理 Nursing of postherpetic neuralgia treated with epidural catheter injection ZHOU Yi-hong,FENG Su-qin,FANG Mei-zhi. The Second Affiliated Hospital of Guangzhou Medical College, Guangzhou 510260,China 【Abstract】 Objective The purpose is to explore characteristics after epidural catheter drug injection in patients with post herpetic neuralgia care.Methods By methods of Epidural catheter by injection for 2 weeks, on 23 cases with severe post herpetic neuralgia, data are obtained then, by observing patients with catheter position before and after, after the catheter tube care, together with complications treatment, VAS score changes within 1 to 2 weeks post operatively and 3-6 months follow-up surgery.Results After 1 week treatment by the specialist care, pains in patients with post herpetic neuralgia were relieved significantly, with VAS score dropped from 6-7 points down to 3-4 points. After 2 weeks treatment, the VAS pain score dropped from 3-4 points down to 1-2 points.Conclusion Neuroprotective drugs with conventional epidural catheter injections in treatment of patients with postherpetic neuralgia, as well as pain management specialist care will result in nerve protection and pain relief. 【Key words】 Epidural catheter injection； Postherpetic neuralgia； Nursing 带状疱疹后遗神经痛是指带状疱疹的皮损已完全治愈，但仍有持续性、剧烈的、非常顽固的和难治性疼痛［1］。患者的疼痛常是自发性闪电样或撕裂样疼痛，发作时常使患者寝食不安，严重影响生活质量。为了有效地尽快消除患者痛苦，笔者所在科对23例带状疱疹后遗神经痛患者行硬膜外腔置管注药治疗并随访，现报道如下。 1 资料与方法 1.1 一般资料 笔者所在科室自2009年4月～2010年6月采用硬膜外腔置管注药治疗23例带状疱疹后遗神经痛患者。其中男11例，女12例，平均年龄63.08岁。 1.2 治疗方法 患者侧卧DSA治疗床上（左侧卧位），先定位穿刺间隙（一般以神经受损定位向上、下两个节段），常规心电监护，开放上肢静脉，常规消毒铺巾，以1%利多卡因进行局部麻醉，在DSA引导下顺利穿刺至