显微微血管减压术在三叉神经痛的临床应用  

Microvascular decompression of trigeminal neuralgia

作　　者：赵冬冬[1] 冯海龙[1] 王奇[1] 张冠妮[1] 

机构地区：[1]四川省人民医院神经外科,四川成都610072

出　　处：《西部医学》2012年第3期547-549,共3页Medical Journal of West China

摘　　要：目的探讨三叉神经痛微血管减压术的手术方法和手术效果。方法分析四川省人民医院神经外科124例行显微微血管减压术患者的临床结果、手术发现及随访资料。结果术后有103例得到随访,平均随访时间2.3年(2个月～9.1年),发作性疼痛彻底缓解92例(89.3%),部分缓解9例(8.7%),无效2例(1.9%))。术中发现88例(71.0%)系动脉压迫,静脉压迫23例(18.5%),在三叉神经出颅处发现一静脉球2例。静脉、动脉同时压迫者8例(6.5%)。另外5例(4.0%)未发现任何血管压迫,术中行三叉神经感觉根后下1/2切断。术后5例发生小脑血肿,其中2例需行开颅血肿清除术。术后脑脊液鼻漏1例。该组病例无一例死亡。结论三叉神经痛微血管减压术是一种安全、有效的手术,但其良好的效果取决于术前患者的选择与术中仔细的操作。Objective To study operative technique and therapeutic effect of microvascular decompression（MVD） of trigeminal neuralgia（TN）.Methods 124 patients who were operated on by microvascular decompression were analyzed about their clinical data,intraoperative finding and follow-up results.Results 103 patients were followed up.Average follow-up time was 2.3 years.Complete pain relief was achieved in 92 patients（89.3%）,9 patients achieved partial pain relief,2 patients had no response.88 patients were suffered by arterial compression,23 patients by venous compression,8 patients by arterial and venous compression,and 5 patients by no vascular compression.5 patients with no vascular compression were operated on by partial sensory rhizotomy.Postoperatively,cerebellar hematomas were formed at 5 patients who were evacuated by craniotomy and cerebrospinal fluid rhinorrhea took place at 1 patient.No patient died.Conclusion MVD of TN is safe and effective,but excellent outcome is dependent on choice of patients and deliberate operative technique.

关 键 词：三叉神经痛 微血管减压术 并发症 

分 类 号：R745.11[医药卫生—神经病学与精神病学]