原发性三叉神经痛的伽玛刀治疗疗效及预后相关因素分析  

Efficacy and relative factors of OUR Gamma knife radiosurgery for essential trigeminal neuralgia

作　　者：闫惊涛[1] 许建新[1] 吕远朝[1] 王鸿云[1] 郭军[1] 

机构地区：[1]山西医科大学第二医院,030001

出　　处：《中国医学创新》2011年第6期20-22,共3页Medical Innovation of China

摘　　要：目的 评估伽玛刀治疗原发性三叉神经痛的疗效及分析预后相关因素.方法 对2000年1月～2008年12月在笔者所在医院接受伽玛刀治疗的103例原发性三叉神经痛患者进行随访研究,评估其疗效,对可能影响预后的因素包括性别、靶区剂量、单双靶点、药物治疗是否有效、术前MRI是否提示三叉神经根受血管压迫以及术前是否行三叉神经微血管减压术因素,进行单因素分析.结果 随访时间6～49个月,平均26个月,根据BNI疼痛量表,随访期内总有效率87.3%（90例）,靶区剂量为80～90 Gy,双靶点、口服药物有效、伽玛刀术前未行微血管减压术可能是伽玛刀治疗TN有效的预后因素.结论 伽玛刀治疗原发性三叉神经痛的有效率可达85%以上,伽玛刀治疗原发性三叉神经痛的预后影响因素还需要进一步研究.Objective To analyze the treatment efficacy and prognostic factors of OUR Gamma Knife Radiosurgery （GKS） in the treatment of essential trigeminal neuralgia（TN）. Methods The clinical data of 103 patients with TN undergoing GKS between January 2000 and December 2008 in our centre were analyzed retrospectively. Post treatment outcomes were analyzed in light of pretreatment patient characteristics, including sex, maximum doses, the target, anticonvulsant responsiveness, imaging evidence of neurovascular conflict and the technique of microvascular decompressjon （MVD）. Univariate analysis were used to determine the prognostic significance of various pretreatment variables. Results The follow - up period was 6 to 49 month（mean 26 month）. At the last evaluation, according to Barrow Neurological Institute （BNI） pain scale, success results were achieved in 87. 3% of patient,with I in 48.5% （50） , Ⅱ in 15.5% （16） and rain 23.3% （24）. Maximum doses,the target,sensitivity to anticouvulsant medication and the technique of microvascular decompression （MVD） were found to be statistically significant. Conclusion Treatment of essential TN with OUR gamma knife radiosurgery has effective rate of 85%. Further study is needed about relative factors of OUR Gamma knife radiosurgery for essential trigeminal neuralgia.

关 键 词：原发性三叉神经痛 伽玛刀 疗效 预后因素 

分 类 号：R745.11[医药卫生—神经病学与精神病学]