微血管减压术治疗复发三叉神经痛与再手术分析  

Analysis on subsequent operation after failed microvascular decompression for trigeminal neuralgia

作　　者：赵长地[1] 孔姣[2] 

机构地区：[1]山东省济宁市第一人民医院神经外科,272111 [2]山东省济宁市第一人民医院微机中心,272111

出　　处：《临床神经外科杂志》2005年第1期16-18,共3页Journal of Clinical Neurosurgery

摘　　要：目的评价微血管减压术治疗一叉神经痛术后无效及复发病例再手术的疗效及随访结果方法对微血管减压术后无效10例和复发25例二叉神经痛病人再次手术探查,据术中不同情况具体处理,并进行4个月至8年的随访结果25例见有血管压迫神经根,涤纶片过大致神经轴弯曲者5例,另5例未探及明显原因分别行微血管减压术(MVD)、MVD+三叉神经感觉根部分切除术(PSR)、PSR、调整涤纶片或神经根松解术术后效果良好,并发症少且轻微随访满意,仅3例轻度复发。结论对MVD术后无效及复发的病人,再次手术探查均应首选,并尽可能行MVD或神经根松解术。Objective To evaluate the effect and follow-up results of subsequent operation after failed microvascular decompression(MVD) of trigeminal neuralgia.Methods 35 cases with sebsequent exploration was performed for lack of pain relief(10 patients) and recurrent neuralgia (25 patients). Specific processing was performed according to different conditions of exploration The mean follow-up period after subsequent operation was 4. 2 years. Rusults Vascular compression of the trigeminal nerve at the root entry zone was observed in 25 ease. Distortion and tilting of the axis ol the norve becausc of dacron sheet too big was found in 5 patients and the findings were negative in the other 5 patients. MVD, MVD and partial sensory rhizotomy (PSR). PSR, adjustment daeron sheet or neurolysis of the trigeminal nerve were performed separately. Good results were obtamed in all patients after subsequent operation and complications were few and minor, Follow-up results were satisfaetory with only light recurrence in 3 cases. Conclusion Subsequent operation should be the first choice to all patients after failed MVD. MVD or neurolysis were performed as far as possible. And PSR still was a efficient and chosed treating method.

关 键 词：微血管减压术 三叉神经痛 复发 再手术 

分 类 号：R745.11[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]