Analysis Of Factors Related To Pain Degree In Acute Stage Of Herpes Zoster And Study Of Nerve Injury By High Frequency Ultrasonography

Objective1.Analyze the relevant factors affecting the degree of pain in the acute stage of herpes zoster in order to provide help for clinical diagnosis and treatment.2.Observed the nerve changes in the corresponding parts of patients with suspected herpes zoster by high frequency ultrasound to provide basis for early diagnosis of herpes zoster.3.Evaluated nerve injury in patients with herpes zoster by high frequency ultrasound,and analyze the correlation between nerve injury and pain.Methods1.Analysis of factors related to pain degree in acute stage of Herpes ZosterThe clinical data of 228 patients with herpes zoster treated in our hospital were collected,such as age,sex,involved nerve,with or without prodromal pan,type of skin lesion,basic disease and serum calcium concentration.According to VRS score,the pain degree of herpes zoster was divided into four grades.Logistic regression and variance analysis were used to analyze the influence of the above factors on the pain degree in the acute stage of herpes zoster.2.Study on nerve injury of Herpes Zoster by High Frequency Ultrasonography.2.1 Clinical data collection: collect the patients who meet the inclusion criteria in our department,and record the basic clinical data such as age,sex,skin lesions,basic diseases and so on.2.2 High-frequency ultrasound observation: LOGIQ E9 ultrasonic diagnostic instrument was used to observe the ultrasonic changes of nerve root and / or cutaneous nerve in the pain corresponding site of patients with suspected herpes zoster,and measure the cross-sectional area of nerve,and analyze the difference of cross-sectional area between affected and healthy side.2.3 Relativity analysis between nerve injury and pain degree: the pain score was scored by VRS score,and the nerve injury degree was evaluated according to the nerve cross-sectional area measured by highfrequency ultrasound in patients with herpes zoster.Finally,the correlation between nerve injury degree and pain degree was analyzed by Spearman correlation analysis.Results1.Analysis of factors related to pain degree in the acute stage of herpes zoster: a total of 228 patients with herpes zoster were collected and analyzed by ordered multi-class Logistic regression analysis.The results showed that age(P<0.001),prodromal pain(P=0.040),skin lesion type(P=0.025)were statistically significant.There was no significant difference in gender(P=0.484),involved nerves(P=0.375,P=0.114,P=0.516),hypertension(P=0.607),diabetes(P=0.505),malignant tumor(P=0.593),calcium(P=0.099).The correlation between age,serum calcium concentration and pain degree was analyzed by variance analysis.the results showed that there was significant difference in age corresponding to different grades of pain(P<0.05),but there was no significant difference in calcium ion(P>0.05).2.High-frequency ultrasound observation: a total of 31 patients with suspected herpes zoster were included in this study,15 cases had rash at the first diagnosis and 16 cases had no rash at the first diagnosis.Fifteen patients with newly diagnosed rash could be clearly diagnosed as herpes zoster.High-frequency ultrasound showed that the echo of the nerve on the affected side was decreased,the structure was confused,and the cross-sectional area of the nerve on the affected side was significantly thicker than that on the healthy side.Among the 16 patients without rash,5 cases showed enlarged nerve edema,followed by typical herpes zoster,which could be diagnosed as herpes zoster;8 cases showed thickened nerve edema without rash,and antiviral treatment was effective.Clinical diagnosis of herpes zoster;there are 3 cases of high-frequency ultrasound showed that the affected side nerve did not change significantly,there was no rash.3.Correlation between the degree of nerve injury and pain: there were 28 patients with herpes zoster.Spearman correlation analysis showed that there was a positive correlation between the degree of nerve injury and the degree of pain(P<0.05).Conclusion1.The severity of pain in the acute stage of herpes zoster is significantly correlated with age,prodromal pain and the type of skin lesions.2.Through the detection of high-frequency ultrasound,the cross-sectional area of the affected side of patients with herpes zoster is significantly larger than that of the healthy side,which is helpful for the diagnosis of herpes zoster.3.High frequency ultrasound can be used to evaluate the degree of nerve injury.The more severe the nerve injury caused by herpes zoster,the more severe the pain.