Clinical Analysis Of 269 Cases Of Herpes Zoster And Research On The Relationship Between The Changes In The Cross-sectional Area Of Cutaneous Nerve In The Affected Area And Pain In 20 Patients

Chapter 1 Clinical analysis of 269 cases of herpes zosterObjective: To explore the characteristics of herpes zoster(Herpes Zoster,HZ)in order to provide reference for the clinical diagnosis and treatment of the disease.Methods: The data of HZ patients hospitalized in the Second Affiliated Hospital of Nanchang University from January 2016 to January 2021 were retrospectively analyzed,and their characteristics were statistically analyzed;the patients were divided into three groups: dermatology,pain department and other departments according to different inpatient departments,to compare the differences between different clinics.Results: A total of 269 patients who met the inclusion criteria were collected,and the number of patients aged 60-80(56.50%)was the largest;the incidence had no obvious seasonality;the rash occurred most on the trunk(57.25%),followed by the head and face;it occurred on the left side of the body HZ on the side was more than on the right side;the incidence rate in women was slightly higher than that in men;pain occurred before rash accounted for 78.81%,and pain preceded shingles without characteristic rash(pre-rash stage).29% of patients in departments other than the department and pain department caused delays in diagnosis and treatment,Among them,the delay rate of the chest and back HZ is the highest at 49.24%;the degree of pain: the head,face and neck were higher than the trunk and limbs,the female patients were higher than the male patients,and the absolute value of monocytes was higher than the normal group.Comparison between the three groups:there was no statistical difference in age,gender,the rash on the left and right sides of the body,and the order of pain and rash;the dermatology group involved more head and face than other groups,and the other groups involved more trunk than skin There were more departments and groups(χ2=13.76,P=0.008);Visual Analogue Scale(VAS)pain score comparison,pain department group> dermatology group>other department groups;the difference was statistically significant(Z=48.60,P<0.001);the Charlson Comorbidity Index(CCI)of other departments was higher than that of dermatology and pain department,and the difference was statistically significant(Z=35.68,P<0.001);VAS score was negatively correlated with CCI index relationship(r=-0.329,P<0.001).Conclusion: Herpes zoster mainly occurs in the elderly,and the trunk is the most common.The female is slightly higher than the male,and the left side is more than the right side.The incidence is not significantly related to the season.Most of them have pain as the first symptom,Patients with HZ occurring in the chest and back are more likely to experience delays in diagnosis and treatment;The increase of cells was related to the pain degree;the main predilection sites,pain degree and comorbidities of patients who were treated in different departments were different;HZ pain degree was negatively correlated with CCI.Chapter 2 A study on the relationship between the changes of the ultrasonic cross-sectional area of the cutaneous nerve in the affected area and pain in 20 patientsObjective: To measure the changes of the ultrasonic cross-sectional area of cutaneous nerve in the affected area of herpes zoster,and to study the relationship between the ultrasonic cross-sectional area of cutaneous nerve and acute pain and Postherpetic Neuralgia(PHN).Materials and methods: 20 patients with herpes zoster were recruited,and the general conditions of the patients,the Visual Analogue Scale(VAS)pain score on admission,serum C-reactive protein,erythrocyte sedimentation rate,the nerve on the affected side and the corresponding contralateral side were collected.Cutaneous nerve cross-sectional area and follow-up for the occurrence of PHN.The relationship between the changes of cutaneous nerve cross-sectional area and acute pain degree and PHN was analyzed.Results: The cross-sectional area of the cutaneous nerve on the affected side of herpes zoster was larger than that on the healthy side(P<0.05).The change of the cross-sectional area of the cutaneous nerve was not correlated with the occurrence of acute pain and PHN.Conclusion: There is inflammatory edema in the cutaneous nerve on the affected side of herpes zoster;however,the degree of cutaneous nerve edema has no correlation with the degree of pain in the acute phase and the occurrence of PHN.