C形臂或CT靶点定位射频治疗三叉神经痛2816例研究  

Trigeminal neuralgia treated by radiofrequency rhizotomy under C-arm Xay or CT-guided location target of ovale foramen:a study of 2816 cases

作　　者：彭胜 刘军 刘垒[3] 刘方铭[3] 吴承远[4] 

机构地区：[1]北京嘉泽东博三叉神经医学研究院,北京100093 [2]彭胜三叉神经医院,山东潍坊261051 [3]山东大学附属千佛山医院疼痛科,山东济南250014 [4]山东大学齐鲁医院神经外科,山东济南250012

出　　处：《中华神经外科疾病研究杂志》2014年第1期59-62,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的介绍C形臂或CT靶点精确定位卵圆孔半月神经节选择性射频热凝治疗原发性三叉神经痛的手术方法、技巧和效果。方法回顾性分析本组2816例射频治疗病例，术中采用C形臂X线或CT定位，靶点位于卯圆孔半月神经节，射频温控热凝术温度设定65～80℃，时间设定为30—60s。近、远期疗效观察并总结分析并发症。结果本组近期随访病例2760例，疼痛完全消失2661例，总有效率96．41％，2年内复发率192例（6．9％），无效39例（1．4％）。结论本手术方法弥补了传统的徒手穿刺的缺陷，提高了定位准确性和疗效。对行开颅微血管减压术（MVD）复发或无效的三叉神经痛患者可以做为一项补充治疗。对本病伴有高龄心脑血管疾病的患者仍是一种安全可靠的治疗方法。Objective To analyze the surgical methods, techniques and effects of selective radiofrequency rhizotomy for trigeminal neuralgia guided by C-arm or CY-guided location target of ovale foramen. Methods The clinical data of 2816 patients with trigeminal neuralgia treated by radiofrequency rhizotomy under C-ann or CT-guided location target of trigeminal ganglion were analyzed retrospectively. The temperature of radiofi＇equency was 65 - 75℃ and the period was 30-60s. The effects and complications were analyzed. Results Among 2760 cases which were followed up, pain disappeared completely in 2661 cases （96. 41% ）, failed in 39 cases （1.4%）, and recurrence occurred in 192 cases （6. 9% ） within 2 years post-operation. Conclusion C-ann or CT-guided selective mdiofrequency rhizotomy for trealment of trigeminal neuralgia is minimally invasive and safe, especially for the elder patients with cardiovascular disease and recurrent cases.

关 键 词：C形臂 CT定位 三叉神经痛 射频 

分 类 号：R745.1[医药卫生—神经病学与精神病学]