腰椎手术后带状疱疹3例分析并文献复习

doi:10.6040/j.issn.1671-7554.0.2018.036

摘要/Abstract

摘要： 目的探讨腰椎手术后带状疱疹的发病危险因素、临床特点及发病规律,提高其预防及诊治水平。方法回顾性分析2015年3月至2017年9月山东大学附属济南市中心医院骨科治疗腰椎手术后带状疱疹3例的临床资料,并对其诊治进行临床总结及分析。结果 3例发病时间分别为腰椎手术后6、8、28 d。给予抗病毒药物阿昔洛韦治疗,同时应用抗感染等对症支持治疗,3例症状均得到缓解。结论手术或创伤后可激活背部神经节中潜伏的水痘-带状疱疹病毒(VZV),增加带状疱疹的发病风险。早期明确手术后带状疱疹的诊断,并给予及时正确的治疗措施,可以避免带状疱疹后遗神经痛、神经性疼痛及其他相关后遗症。

关键词: 水痘-带状疱疹病毒, 带状疱疹, 腰椎手术

Abstract: Objective To improve the prevention, diagnosis and treatment of herpes zoster after lumbar spine surgery. Methods The clinical data of 3 cases of herpes zoster following lumbar spine surgery treated during Mar. 2015 and Sep. 2017 were retrospectively analyzed. Results The patients developed herpes zoster 6, 8 and 28 days after lumbar spine surgery, respectively. After antiviral, anti-infection and other support therapies, the symptoms were relieved. Conclusion Varicella-zoster virus can be reactivated by surgery or trauma. Early recognition and timely therapeutic intervention are essential to avoid postherpetic neuralgia, neuropathic pain and other related sequelae.

Key words: Varicella-zoster virus, Herpes zoster, Lumbar spine surgery

中图分类号:

R681.5

王鹏,龚维明,张足昌,宋宏亮,宁斌,赵凯,仲江波. 腰椎手术后带状疱疹3例分析并文献复习[J]. 山东大学学报 (医学版), 2018, 56(6): 91-94.

WANG Peng, GONG Weiming, ZHANG Zuchang, SONG Hongliang, NING Bin, ZHAO Kai, ZHONG Jiangbo. Herpes zoster following lumbar spine surgery: a report of 3 cases and literature review[J]. Journal of Shandong University (Health Sciences), 2018, 56(6): 91-94.

参考文献

[1] 李娟, 索罗丹, 赵丹, 等. 带状疱疹的流行病学研究进展[J]. 现代预防医学, 2014, 41(5): 781-784. LI Juan, SUO Luodan, ZHAO Dan, et al. Epidemiological study of herpes zoster[J]. Modern Preventive Medicine, 2014, 41(5): 781-784.
[2] Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults[J]. N Engl J Med, 2005, 352(22): 2271-2284.
[3] Dunst J, Steil B, Furch S, et al. Herpes zoster in breast Cancer patients after radiotherapy[J]. Strahlenther Onkol, 2000, 176(11): 513-516.
[4] Rusthoven JJ, Ahlgren P, Elhakim T, et al. Varicella-zoster infection in adult Cancer patients. A population study[J]. Arch Intern Med, 1988, 148(7): 1561-1566.
[5] Arvin AM. Varicella-Zoster virus: pathogenesis, immunity, and clinical management in hematopoietic cell transplant recipients[J]. Biol Blood Marrow Transplant, 2000, 6(3): 219-230.
[6] Kang TY, Lee HS, Kim TH, et al. Clinical and genetic risk factors of herpes zoster in patients with systemic lupus erythematosus[J]. Rheumatol Int, 2005, 25(2): 97-102.
[7] Thomas SL, Wheeler JG, Hall AJ. Case-control study of the effect of mechanical trauma on the risk of herpes zoster[J]. BMJ, 2004, 328(7437): 439.
[8] Anderson MD, Tummala S. Herpes myelitis after thoracic spine surgery[J]. J Neurosurg Spine, 2013, 18(5): 519-523.
[9] Drazin D, Hanna G, Shueikeh F, et al. Varicella-zoster-mediated radiculitis reactivation following cervical spine surgery: Case Report and Review of the Literature[J]. Case Rep Infect Dis, 2013: 647486. doi: 10.1155/2013/647486.
[10] Muesse JL, Blackmon SH, Harris RL, et al. Acute shingles after resection of thoracic schwannoma[J]. Tex Heart Inst J, 2012, 39(2): 265-267.
[11] Guha-Thakurta N, Dang BN, Azeem S, et al. Postoperative varicella-zoster virus myelopathy and dissemination[J]. Arch Neurol, 2011, 68(10): 1340-1341.
[12] Salomon A, Delanghe F, Jeanjean P. Postoperative herpetic meningoencephalitis after lumbar surgery: a case report[J]. Ann Fr Anesth Reanim, 2010, 29(10): 732-735.
[13] Grauvogel J, Vougioukas VI. Herpes radiculitis following surgery for symptomatic cervical foraminal stenosis[J]. Can J Neurol Sci, 2008, 35(5): 661-663.
[14] Godfrey EK, Broun C, Stambough JL. Herpes zoster-varicella complicating anterior thoracic surgery: 2 case reports[J]. J Sprinal Disord Tech, 2006, 19(4): 299-301.
[15] Weiss R. Herpes zoster following spinal surgery[J]. Clin Exp Dermatol, 1989, 14(1): 56-57.
[16] Nabors MW, Francis CK, Kobrine AI. Reactive of herpesvirus in neurosurgical patients[J]. Neurosurgery, 1986, 19(4): 599-603.
[17] Haverkos HW, Pazin GJ, Ho M, et al. Reactivation of type 2 herpes simplex virus by thoracolumbar neurosurgery[J]. Ann Intern Med, 1984, 101(4): 503-504.
[18] Hung CH, Chang KH, Kuo HC, et al. Features of varicella zoster virus myelitis and dependence on immune status[J]. J Neurol Sci, 2012, 318(1-2): 19-24.
[19] Poissy J, Wolff M, Dewilde A, et al. Factors associated with delay to acyclovir administration in 184 patients with herpes simplex virus encephalitis[J]. Clin Microbiol Infect, 2009, 15(6): 560-564.
[20] Makkar JK, Singh NP, Rastogi V. Herpes zoster: are selective nerve root injections the treatment or the caus?[J]. Pain Physician, 2010, 13(2): 196-198.
[21] Conliffe TD, Dholakia M, Broyer Z. Herpes zoster radiculopathy treated with uoroscopically-guided selective nerve root injection[J]. Pain Physician, 2009, 12(5): 851-853.
[22] Singh D, Kennedy DH. The use of gabapentin for the treatment of postherpetic neuralgia[J]. Clin Ther, 2003, 25(3): 852-889.
[23] Bowsher D. The effects of pre-emptive treatment of postherpetic neuralgia with amitriptyline: a randomized, double-blind, placebo-controlled trial[J]. J Pain Symptom Manage, 1977, 13(6): 327-331.
[24] Sawyer MH, Chamberlin CJ, Wu YN, et al. Detection of varicella-zoster virus DNA in air samples from hospital rooms[J]. J Infect Dis, 1994, 169(1): 91-94.

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