Objective:This study aimed to assess the effects of different concentrations of gaseous ozone and ozonated water injection around gasserian ganglion on the patient with trigeminal neuralgia.Methods:Collected the data of patients who suffered from trigeminal neuralgia from November 2016 to November 2021 in the Aviation General Hospital and the Affiliated Hospital of Shandong Second Medical University,then divided into 3 groups 23 μg/ml ozonated water injection group(23 patients),30 μg/ml gaseous ozone injection group(31 patients),40 μg/ml gaseous ozone injection group(17 patients).The therapeutic efficacy was evaluated via visual analogue scale(VAS),Barrow neurological institute(BNI)pain score and tactile sensation at pre-treatment and 1 week,6 months,1 year,post-treatment.Results:The VAS and BNI scores in the three groups at different time points were significantly lower than pre-treatment.Compared with 23 μg/ml ozonated water injection and 40 μg/ml gaseous ozone injection groups,the VAS,and BNI scores of the 30 μg/ml gaseous ozone injection group were lower 1 week after treatment.Similarly,the tactile sensation was significantly decreased at post-treatment compared to pre-treatment(P<0.05).However,there was no statistical difference among the three groups,and no significant complications were observed after 23 μg/ml ozonated water injection.Conclusion:23 μg/ml ozonated water injection,30 μg/ml gaseous ozone injection and 40 μg/ml gaseous ozone injection are effective therapies for treating TN.23 μg/ml ozonated water injection has a lower risk of potential complications and is safer in clinical applications.

目的 探讨原发性三叉神经痛患者应用A型肉毒毒素联合普瑞巴林治疗的临床效果.方法 选择兰州市妇幼保健院于2017年2月至2021年2月收治的60例原发性三叉神经痛患者为研究对象,按照随机数字表法将其分为对照组和观察组,每组30例.对照组患者选择瑞普巴林治疗,观察组患者选择A型肉毒毒素联合瑞普巴林治疗.比较两组患者疗效,治疗前后疼痛视觉模拟评分(VAS)评分、综合症状评分、血清降钙素基因相关肽(CGRP)及5-羟色胺(5-HT)水平.结果 观察组患者治疗总有效率高于对照组(P<0.05);治疗后,观察组患者V A S评分、综合症状评分、CGRP水平均低于对照组,5HT水平高于对照组(P<0.05).结论 应用A型肉毒毒素联合普瑞巴林治疗原发性三叉神经痛可提高患者疗效,改善其临床症状,缓解疼痛,值得临床应用推广.

目的:比较CT引导下半月神经节射频热凝术与三氧注射治疗三叉神经痛的疗效.方法:收集2014至2020年因三叉神经痛接受治疗的病人诊疗信息,按手术方法分为经皮射频热凝术(percutaneous radiofrequency thermocoagulation,PRT)组14例和三氧注射治疗(ozone therapy,OT)组13例;并进行随访.采用视觉模拟评分法(visual analogue scale,VAS)评分及巴罗神经学研究所(Barrow neurological institute,BNI)疼痛评分,评估病人疼痛(pain)和麻木(numbness)程度.结果:两组治疗前VAS,BNI(P)和BNI(N)评分差异均无统计学意义.治疗后1周VAS和BNI(P)评分均降低;但OT组高于PRT组.治疗后BNI(N)评分OT组均低于PRT组.随访期间PRT组2例疼痛复发,病人均有麻木症状;OT组5例病人偶发轻微疼痛,均无麻木症状.结论:OT和PRT均可缓解三叉神经痛,OT缓解疼痛的效果略低于PRT,但OT组的病人术后麻木程度低于PRT组.

目的:回顾分析预防性硬膜外血补丁(prophylactic epidural blood patch,PEBP)用于硬脊膜穿刺后头痛(post-dural puncture headache,PDPH)的疗效和可行性.方法:本中心共进行671次蛛网膜下隙穿刺以治疗神经病理性疼痛相关疾病,根据穿刺部位不同分为三组:枕大池穿刺组(CM组,n=41)、颈椎穿刺组(C组,n=51)和腰椎穿刺组(L组,n=579),探究穿刺部位对PDPH的影响.根据是否实施PEBP将L组分为两个亚组:预防组(PL组n=104)和未预防组(NL组,n=475),探究PEBP能否有效预防PDPH.结果:NL组、C组和CM组PDPH发生率分别为8.63％、1.96％和0.NL组高于CM组(P<0.05)和C组(P=0.068);PL组PDPH发生率为0.96％,显著低于NL组(P<0.01).结论:蛛网膜下隙穿刺部位影响PDPH发生率;PEBP可有效预防PDPH.

目的:回顾性分析带状疱疹后神经痛(postherpetic neuralgia,PHN)病人痛觉异常的影响因素.方法:将425例病人分为E组(≥65岁)和M组(年龄<65岁),分析病人一般信息,临床症状.根据病程再分为三个亚组:1≤6月:E1、M1,6≤24月:E2、M2,≥24月:E3、M3,比较各亚组疼痛程度、特征,Logistics回归分析痛觉异常可能的影响因素.结果:E组疼痛程度显著高于M组,E1,E2组疼痛程度明显高于M1,M2组;E组痛觉过敏和痛觉超敏发生率高于M组,均以M3和E3亚组区别显著.Logistics分析结果示:痛觉过敏发生率与病人年龄呈正相关;带状疱疹急性期抗惊厥药治疗可减少痛觉异常发生;神经毁损则相反.结论:老年病人疼痛更剧烈,更易伴随痛觉过敏;急性期抗惊厥药可有效降低痛觉异常发生,但神经毁损相反.

直肠三氧灌注疗法是指将医用三氧通过直肠注入作用于人体,以达到预防和治疗疾病目的的一种疗法.近年来有关直肠三氧灌注的基础研究与临床报道越来越多.作者系统地综述该疗法在基础研究和临床工作中研究进展,有利于该疗法的研究和应用.

Objective To investigate the clinical efficacy of temperature-controlled plasma radiofrequency ab-lation combined with ozone injection in the treatment of cervical disc herniation.Methods Sixty patients with cervical disc herniation who treated in our hospital from January 2014 to December 2016 were selected,which were divided into observation group and control group according to the random number table,with 30 cases in each group.The observa-tion group was treated with temperature-controlled plasma radiofrequency ablation combined with ozone injection nucle-us ablation,while control group was treated with temperature-controlled plasma radiofrequency ablation.The visual ana-logue pain score(VAS),Oswestry dability index(ODI),height of the intervertebral space and the clinical efficacy of the two groups were observed before treatment,1 week,1 month and 3 months after treatment.Results There was no sig-nificant difference between the observation group and control group in VAS scores(8.24±1.04)vs(8.38±1.06)and ODI scores(32.26±6.75)vs(34.36±6.88)before treatment(P>0.05).At 1 week,1 month and 3 months after treatment,the VAS scores of observation group were(2.37±1.07),(1.75±1.08),(0.93±1.01)respectively,and the VAS scores of control group were (2.95±1.08), (2.54±1.10), (1.72±1.08);The ODI scores of observation group were (15.25±3.65), (11.36± 4.08),(8.22±2.54),and the ODI scores of control group were(24.66±4.65),(23.75±6.54),(18.68±5.23).The VAS scores and ODI scores after treatment in the two groups were decreased than those before treatment,and the VAS scores and ODI scores of observation group were lower than those of control group(P<0.05).There was no significant difference between the observation group and control group in disc height before treatment,1 week,1 month and 3 months after treatment:(0.21±0.03)mm vs(0.22±0.02)mm,(0.21±0.02)mm vs(0.22±0.03)mm,(0.21±0.02)mm vs(0.21±0.03) mm,(0.22±0.02)mm vs(0.22±0.03)mm,P>0.05.The excellent and good rate of observation group was 96.67%,which was significantly higher than 80.00% of the control group(P<0.05).Conclusion Temperature-controlled plasma radio-frequency ablation combined with ozone injection can effectively alleviate the symptoms and pain of patients with cervi-cal disc herniation,which can improve cervical function of patients,and its therapeutic effect is better than that of tem-perature-controlled plasma radiofrequency ablation.

Chemotaxis is a common response of non-excitable cells stimulated by chemokine.The chemokine receptor of neurons often transducts cascade via activating the heterotrimeric G protein downstream signals and further triggers molecular signal transduction pathway.Chemokines and their receptors play an important role in the occurrence and maintenance of pain.By analyzing the relationship between chemokines and nerve systems,the relationship between chemokines/chemokine receptors and pain,we demonstrated the mechanism of action of chemokines and their receptors in the pathogenesis of pain,suggesting that chemokines and their receptors are potential targets for the development of novel drugs and options for pain management.

<正>血管瘤是婴幼儿中最常见的良性肿瘤之一,其治疗方法有很多,多数给予局部麻醉,我科应用静脉复合麻醉减轻患儿疼痛提高注射疗效,取得了满意的效果。现将护理体会报道如下。

Objective To discuss the effect of treating surface hemangioma of infants by prednisone acetate taken orally with triamcinolone acetonide.Methods We Collected,analyzed and observed the clinical data obtained from two ways treating haemangioma from Eleven 2006 to October 2010 in our division.Results Followed up 3 months to 3 years,the effect of just taking prednisone acetate orally is 80.64%,the combinated one is 95.74%.There were significant difference between two ways(χ2=4.627,P0.05).Conclusion According to the size and location of haemangioma,with the combination of prednisone acetate and triamcinolone acetonide,the treation to the haemangioma gains great effect.

Objective To discuss the curative effect of injecting Triamcinolone Acetonide locally treating infant hemangioma controlly with taking Prednisone acetate orally.Methods 23 infants in the team,tumour proportion:0.6cm×1cm～5cm×6cm,the age of infant be treated firstly:2 months to 1 year old,the first week to the tenth week of taking Prednisone acetate orally,3.0～5.0mg/kg,the gross less than 50kg,taken at a draught in tertian morning.Follow up one time after 2 weeks of the injection.Results Excellence:17cases(74.0%),utility:5cases(21.7%),ineffective:1cases(4.3%).Conclusion In this team,23 cases got better effect by injecting Triamcinolone Acetonide locally treating infant hemangioma on body surface controlly with taking Prednisone Acetate orally.The operation is simple and inexpensive,without surgery.

<正>血管瘤是婴幼儿较常见的疾病,好发于头面部,严重影响患者外貌。目前治疗的方法有很多种,自2007年3月～2009年12月,我们应用醋酸泼尼松治疗血管瘤18例,取得了满意的疗效,现报道如下。

目的:观察咪唑安定、丙泊酚复合氯胺酮麻醉应用于小儿体表海绵状血管瘤的注射治疗的麻醉效果.方法:随机选择小儿体表海绵状血管瘤患者62例,分为对照组(氯胺酮组),观察组(应用咪唑安定、丙泊酚复合氯胺酮麻醉);无水酒精+平阳霉素注射治疗小儿体表海绵状血管瘤.观察镇静及遗忘程度,平均动脉压、心率、脉搏、血氧饱和度等指标.结果:观察组在注射治疗期间能充分耐受由注射治疗所带来的疼痛,术中无知晓,血流动力学平稳.结论:咪唑安定、丙泊酚复合氧胺酮麻醉较单纯氯胺酮麻醉应用于小儿体表海绵状血管瘤注射治疗效果满意,是一种可取的麻醉方法.