原发性三叉神经痛伽玛刀治疗(附838例分析)  

Gamma Knife Treatment for Primary Trigeminal Neuralgia

作　　者：吴高峰 雷进 吴娜娜[2] 廖述才 

机构地区：[1]成都363医院,四川成都610041 [2]成都市第一人民医院,四川成都610041

出　　处：《四川医学》2016年第3期296-298,共3页Sichuan Medical Journal

摘　　要：目的评价伽玛刀治疗原发性三叉神经痛的疗效及相关因素。方法采用1.5T核磁共振影像,GammaTPS治疗计划系统,OUR伽玛刀治疗原发性三叉神经痛838例,治疗靶点在三叉神经感觉根进入桥脑处（REZ区）,用4mm准直器,中心最大剂量70~90Gray。以50%等剂量曲线覆盖靶点,脑干边缘剂量为15~16Gy。结果 586例随访3~48个月,疼痛完全缓解410例（70%）;疼痛基本消失（缓解〉80%）59例（10%）;疼痛缓解〉50%有83例（14.2%）;无效34例（5.8%）,总有效率为94.2%。23例（3.9%）出现一过性轻度面部麻木、感觉减退,无其他并发症。结论伽玛刀治疗原发性三叉神经痛疗效显著、安全,是一种理想的治疗方法。Objective To evaluate the efficacy of gamma knife in the treatment of primary trigeminal neuralgia and its related factors. Methods We use 1. 5T magnetic resonance imaging,Gamma-TPS treatment planning system treated 838 cases of primary trigeminal neuralgia. The therapeutic targets were at the zone where the sensory root of the trigeminal nerve enters pons（ REZ）,and with 4 mm collimator,the maximum central dose was 70 ~ 90 Gray. We cover the targets with 50% isodose curve and the dose at brainstem margin was 15 ~ 16 Gy. Results 586 cases were followed up for 3 to 48 months,among which there were410 patients（ 70%） with complete pain relief（ 70%）,59 patients（ 10%） whose pain basically disappeared（ relieved more than80%）,83 patients（ 14. 2%） whose pain relieved more than 50% and 34 patients（ 5. 8%） receiving no effect. The total effective rate was 94. 2%,while 23 petients（ 3. 9%） had transient mild facial numbness and hypoesthesia,but no other complications. Conclusion Gamma knife,in the treatment of primary trigeminal neuralgia,is significant and safe as an ideal therapeutic method.

关 键 词：原发性三叉神经痛 伽玛刀 三叉神经感觉根 

分 类 号：R745.11[医药卫生—神经病学与精神病学]