DZY-B型三叉神经定向仪治疗三叉神经痛的临床应用研究  

The clinical study of trigeminal stereoguide (DZY-B type) for treatment of trigeminal neuralgia

作　　者：陈小华[1] 董意如[2] 劳雨旋[1] 邓柏杰[1] 张继平[1] 曾令雄[1] 

机构地区：[1]佛山市中医院,528000 [2]南京铁道医学院附院神经外科

出　　处：《立体定向和功能性神经外科杂志》2000年第1期22-24,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的 :从 1990年 12月至 1998年 10月 ,135例三叉神经痛随机分为两组。一组用立体定向仪 (DZY - B型 )经皮穿刺注射甘油治疗 (定向组 ) ;另一组用 Hartel徒手穿刺法注射甘油治疗 (徒手组 )。比较两组的穿刺成功率和解痛疗效。方法 :定向组 :将定向仪固定在病人头上 ,摄 X线颅底及侧位片 ,测算卵圆孔的三维坐标值 ,在立体定向仪的导引下 ,穿刺针通过卵圆孔进入三叉神经池。缓慢注入 99.5 %甘油 (0 .2～ 0 .4ml)。徒手组 :则用 Hartel法进行穿刺 ,然后进行甘油注射治疗。结果 :定向组的穿刺成功率为 10 0 % ,徒手组为 88.7%。定向组的完全解痛率为 98% ,部分解痛率为 2 % ,总的疗效为 10 0 % ;而徒手组则为 85 .7% ,2 .85 % ,88.5 5 % (P<0 .0 1) ,差异有非常显著的意义。结论 :临床应用研究表明 :应用立体定向仪穿刺法的优点是穿刺准确 ,成功率高 ,解痛疗效好 ,手术并发症少 ,安全性和疗效均比徒手穿刺好。Objective:To compare the successful puncture rate and pain relief rate between the two groups,trigeminus stereoguide apparatus(DZY B type)(T.S.group),and free hand technique(F.H.group).Methods:For the patients of T.S.group,the trigeminus stereoguide apparatus(DZY B type)was fixed on the patient's head.Base skull(sub mentovertical)and lateral X ray film was taken for measuring three dimensional coordinate of foramen ovale Under the stereotactic guiding,the puncture needle was passed throngh the foramen ovale to the trigeminal cistern.99.5% glycerol(0.2～0.4ml) was slowly injected.For the patients of F.H.group,the percutaneous glycerol rhizotomy was done by means of Hartel's free hand technique.Results:In the T.S.group,the successful puncture rate was 100(100%),compared with 88.7% in the F.H.group.In the T.S.group,the complete pain relief rate was 98%,partial pain relief rate was 2%,overall effective pain free rate was 100%,corresponding figure in the F.H.group were 30(85.7%),1(2.85%),88.55%.This yielded a P value<0.01,indicating a significant difference between the two group.Conclusion:The clinical study reveal that the technique of trigeminus stereoguide puncture is better than the free hand puncture for treatment of trigeminal neuralgia.Its main advantage is the accurate puncture,good pain free result and rarity operative complication.

关 键 词：三叉神经痛 立体定向仪 甘油注射 治疗 

分 类 号：R745.110.5[医药卫生—神经病学与精神病学]