微血管减压术治疗功能性脑神经疾病(附496例临床分析)  

Microvascular decompression in the treatment of functional brain disease(The clinical analysis of 496 cases)

作　　者：陈成雨[1] 韩凤珍[1] 刘琨[1] 侯青松[1] 刘森[1] 郭延勇[1] 李彬[1] 吕涛[1] 

机构地区：[1]山东济宁医学院附属第二医院神经外科,济宁272051

出　　处：《立体定向和功能性神经外科杂志》2010年第1期23-26,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨微血管减压术治疗功能性脑神经疾病的临床价值、手术中的处理选择及并发症的预防。方法采用耳后小切口微血管减压术治疗功能性脑神经疾496例,共504例次手术,三叉神经痛408例,共进行了416例次手术;面肌痉挛82例;舌咽神经痛6例。术中根据血管与神经的压迫关系分为单纯接触、袢状压迫、黏连包绕和贯穿等4型,并根据不同的压迫类型进行不同的处理。结果本组经1年以上随访,三叉神经痛第一次术后疼痛立即消失312例,明显进步59例,进步24例,无效6例,复发6例。面肌痉挛术后62例抽搐停止,19例术后仍有面部不同程度的抽搐,3例病人无效。舌咽神经痛术后疼痛均消失,无复发。结论微血管减压术治疗功能性脑神经疾病效果肯定,其疗效与血管压迫神经的类型有关。Objective To explore the clinical value of microvascular decompression in the treatment of functional brain diseases,choice in the treatment and the prevention of complications.Methods Patients with functional brain disease were executed with microvascular decompression in the small incision behind ear,408 patients with trigeminal neuralgia and 82 patients with hemifacial spasm and 6 patients with glossopharyngeal neuralgia under the same operation method.The relationship of blood vessels and nerve included a simple contact,loop-like oppression,adhesion and cross-cutting,and the treatment of different types of oppression were different.Results The follow-up by more than 1 year,pain in 312 patients with trigeminal neuralgia pain immediately disappeared after the first operation,and 59 cases of apparent progress,24 cases of progress,6 cases of recurrence.62 patients with Hemifacial spasm had stopped the convulsions after the operation,but 19 patients still suffered from varying degrees of convulsion,three cases of patients invalid.Pain disappeared in the patients with Glossopharyngeal neuralgia,no relapse.Conclusion Microvascular decompression was safe and effective in the treatment of functional brain diseases,and its efficacy was related to the type of the relationship blood vessels and nerve.

关 键 词：微血管减压术 三叉神经痛 面肌痉挛 舌咽神经痛 

分 类 号：R745.11[医药卫生—神经病学与精神病学]