伽玛刀双靶点治疗原发性三叉神经痛的临床研究  

Clinical study of Gamma knife radiosurgery with double targets for idiopathic trigeminal neuralgia

作　　者：方俊杰[1] 赵洪洋[1,2] 杨卫忠[1] 

机构地区：[1]福建医科大学附属协和医院神经外科,福建省神经外科研究所,福州350001 [2]华中科技大学同济医学院附属协和医院神经外科

出　　处：《中国神经精神疾病杂志》2009年第6期339-341,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的评价使用伽玛刀双靶点治疗原发性三叉神经痛的疗效和安全性。方法对32例原发性三叉神经痛病人采用双靶点治疗,以三叉神经根近桥脑处和近半月节处为照射靶点,中心剂量84～90Gy,周边剂量42～45Gy,桥脑临界剂量<20Gy。结果本组32例获随访,均有疼痛缓解,按BNI评分,有效率为96.9%。起效时间平均4.2个月(1d～26个月)。8例(25%)复发,8例(25%)出现并发症。结论双靶点治疗能有效缓解三叉神经痛,提高患者生活质量。Objective To investigate the effectiveness and complications of the treatment of idiopathic trigeminal neuralgia using Gamma knife radiosurgery with double targets. Methods From January, 2002 till December, 2004 there were 32 patients who underwent Gamma knife surgery with double targets. The root entry zone and eisternal retrogasserian part of trigeminal nerve near the Gasserian ganglion were selected as targets. The maximum close of irradiation was 84 ~ 90 Gy and the marginal dose was 42 ~ 45 Gy. The critical dose to pons was controlled below 20 Gy. The patients were followed up after radiosurgery to investigate complications and pain relief. Results Thirty one （96.9%） patients reported pain relief （BNI class Ⅰ, Ⅱ or Ⅲ ） at a mean of 4. 2 months （range, 1 clay - 26 months following treatment. Eight （25%） patients reported recurrences of pain at a mean of 13.5 months after therapy （range, 3 clays- 5 years）. Eight （25%） patients had tolerable numbness or paresthesias. Conclusions GKS with double targets is an effective surgical approach for idiopathic trigeminal neuralgia.

关 键 词：伽玛刀 双靶点 原发性三叉神经痛 

分 类 号：R745.11[医药卫生—神经病学与精神病学]