CT引导下蝶腭神经节射频热凝术治疗蝶腭神经痛的长期疗效及安全性分析  

Long- term Efficacy and Safety of CT Guided Sphenopalatine Ganglion Radiofrequency Thermocoagulation in the Treatment of Sphenopalatine Neuralgia

作　　者：李娜[1,2] 郭玉娜[1] 秦红军[1,3] 贾绍芳[1] 左欣鹭 杨惠婕[1] 倪家骧[1] 

机构地区：[1]首都医科大学宣武医院疼痛科,北京市100053 [2]大庆油田总医院麻醉科 [3]北京电力医院放射科 [4]承德护理职业学院

出　　处：《中国全科医学》2016年第12期1375-1378,共4页Chinese General Practice

基　　金：北京市医院管理局医学发展专项--“扬帆”计划(ZYLX201507)

摘　　要：目的探讨CT引导下蝶腭神经节射频热凝术治疗蝶腭神经痛（SPN）的长期疗效及安全性。方法选取2005年10月—2014年5月首都医科大学宣武医院疼痛科收治的行CT引导下蝶腭神经节射频热凝术治疗的SPN患者8例,自2005年10月开始对患者进行电话随访,随访至2015年12月,随访时间为19-122个月,平均（55.4±12.8）个月。记录患者术前疼痛数字评分（NRS）和视觉模拟评分（VAS）,术后3 d和术后1个月、3个月、6个月、1年、2年、3年、5年、7年、10年的NRS、VAS及疼痛缓解情况,术后不良反应（包括视力障碍、面部血肿、颅内感染、体位性低血压、晕厥等）情况。结果术后3 d疼痛缓解率为100.0%。患者均顺利完成随访,术后1个月、3个月、6个月、1年、3年、5年、7年、10年的疼痛缓解率均为100.0%;术后2年疼痛缓解率为87.5%,1例（12.5%）患者术后第16个月症状复发,口服盐酸曲马多缓释片控制疼痛,准备再次行CT引导下射频热凝术。术前患者（8例）NRS为（8.4±1.4）分、VAS为0分;术后3 d患者（8例）NRS为（0.3±0.7）分、VAS为（2.6±5.6）分;术后1、3、6、12个月患者（8例）NRS均为0分,VAS分别为（1.5±1.3）分、（1.1±1.1）分、（0.5±0.9）分、0分;术后2年患者（6例）NRS为0分、VAS为0分;术后3、5年患者（4例）NRS分别为0分、（0.5±1.0）分,VAS均为0分;术后7年患者（2例）NRS、VAS均为0分;术后10年患者（1例）NRS为2分、VAS为0分。患者术后未出现视力障碍、面部血肿、颅内感染、体位性低血压甚至晕厥等严重不良反应。结论 CT引导下蝶腭神经节射频热凝术治疗SPN可有效缓解疼痛,且维持时间长,是一种安全、有效的微创治疗方法。Objective To investigate the long - term efficacy and safety of CT guided sphenopalatine ganglion radiofrequency thermocoagulation in the treatment of sphenopalatine neuralgia（ SPN）. Methods The study enrolled 8 SPN patients who received CT guided sphenopalatine ganglion radiofrequency thermocoagulation in the Department of Pain Management,Xuanwu Hospital Capital Medical University from October 2005 to May 2014. Telephone follow - up was conducted on patients from October 2005 to December 2015,lasting for 19 - 122 months with（55. 4 ± 12. 8）months on average. NRS and VAS of patients before surgery were recorded,and NRS,VAS and pain relief status were recorded 3 days,1 month,3 months, 6 months,1 year,2 years,3 years,5 years,7 years and 10 years after surgery,and postoperative reactions were observed （including visual impairment,facial hematoma,intracranial infection,postural hypotension and syncope）. Results The 3 days pain relief rate was 100. 0% after surgery. All the patients completed follow - up,and 1 month,3 months,6 months,1 year,3 years,5 years,7 years and 10 years pain relief rates were all 100. 0% after surgery;2 years pain relief rate was 87. 5%after surgery;one（12. 5% ）patient who had relapse 16 months after surgery had pain controlled after the oral administration of tramadol hydrochloride sustained - release tablets and prepared to take CT guided sphenopalatine ganglion radiofrequency thermocoagulation again. Before surgery,the NRS and VAS of the 8 patients were（8. 4 ± 1. 4）and 0;3 days after surgery,the NRS and VAS of the 8 patients were（0. 3 ± 0. 7）and（2. 6 ± 5. 6）;1 month,3 months,6 months and 12 months after surgery,the VAS was（1. 5 ± 1. 3）,（1. 1 ± 1. 1）,（0. 5 ± 0. 9） and 0 respectively and the NRS was all 0;2 years after surgery,the NRS and VAS of 6 patients were both 0;3 years and 5 years after surgery,the NRS of 4 patients was 0 and（0. 5 ± 1. 0 ）respectively,and VAS was all 0;7 years after surgery,NRS and VAS of 2 patients were both 0;10 years

关 键 词：面神经痛 体层摄影术 螺旋计算机 射频热凝术 治疗结果 

分 类 号：R745.12[医药卫生—神经病学与精神病学]