MVD和PRF治疗原发性三叉神经痛效果比较的系统评价  

Comparison on MVD and PRF for trigeminal neuralgia:a systematic review

作　　者：颜雅慧[1] 李卫星[2] 

机构地区：[1]山西医科大学口腔学院,山西太原030001 [2]山西医科大学口腔医院,山西太原030001

出　　处：《中国当代医药》2012年第13期157-159,共3页China Modern Medicine

摘　　要：目的系统评价射频热凝术(PRF)和微血管减压术(MVD)治疗原发性三叉神经痛的临床疗效。方法采用Cochrane系统评价的方法,计算机检索Cochrane图书馆、Medline、CBM、CNKI数据库有关射频热凝术与微血管减压术的RCT和临床对照研究的文献,检索时间截止2011年。在严格筛选资料和质量评价的基础上,采用RevMan5.0软件对纳入的研究进行Meta分析。结果最终有10篇文献符合纳入标准。Meta分析结果显示:(1)疼痛缓解率,MVD手术的疼痛缓解率比PRF手术的疼痛缓解率要高[OR=1.72,95%CI(1.17～2.52),P=0.006]。(2)手术复发率,MVD术后复发率比PRF要低[RR=0.25,95%CI(0.11～0.55),P=0.0007]。(3)并发症率,MVD术后出现并发症的患者例数比PRF要少[OR=0.38,95%CI(0.19～0.75),P=0.005]。结论现有证据表明,MVD的整体效果要优于PRF,表现在疼痛缓解迅速,复发率低,并发症少。但纳入样本量较少,方法学质量评价不高,在一定程度上降低了系统评价的说服力。Objective To evaluate the clinical effectiveness of microvascular decompression （MVD） and percutaneous radiofrequency thermocoagulation（PRF） in trigeminal neuralgia（TN）.Methods According to the Cochrane book for systematic reviews,a fully recursive literature search was conducted in Cochrane Central Register,Medline,CBM,CNKI.By using a defined search strategy,both the randomized controlled trials （RCTs） and controlled clinical trials on comparing MVD with PRF in trigeminal neuralgia were identified.The data was extracted and evaluated.The quality of the included trials was evaluated.Meta-analyses were conducted using the Cochrane Collaboration＇s RevMan 5.0 software.Results Ten controlled clinical trials were included.The results of meta-analyses showed that：（1）The pain relief rate in MVD was higher than PRF with significant difference OR=1.72,95%CI（1.17-2.52）,P=0.006;（2）The recurrence rate of MVD was lower than PRF group with significant difference RR=0.25,95%CI （0.11-0.55）,P=0.000 7;（3） The complications rate in the MVD group was lower than that of the PRF group with significant difference OR=0.38,95%CI（0.19-0.75）,P=0.005.Conclusion Currently evidence suggests that,the overall effect of MVD is better than PRF in more rapid pain relief,lower recurrence rate,fewer complications.For the influencing factors of few samples and lower quality methodological samples,the system evaluation of persuasion reduces in a certain extent.

关 键 词：三叉神经痛 射频热凝术 微血管减压术 系统评价 Meta分析 

分 类 号：R745.11[医药卫生—神经病学与精神病学]