神经内镜结合小切口在老年人原发性三叉神经痛手术加速康复外科中的应用  

Application of neuroendoscope combined with minimal-access for elderly patients with idiopathic trigeminal neuralgia in enhanced recovery after surgery of microvascular decompression

作　　者：李传峰[1] 吴娜[1] 王厚中[1] 张继方[1] 吴国庆[1] 李洛[1] 

机构地区：[1]青岛大学附属青岛市市立医院神经外科,266071

出　　处：《中华医学杂志》2017年第27期2116-2119,共4页National Medical Journal of China

摘　　要：目的探讨神经内镜及小切口在老年人原发性三叉神经痛手术的加速康复外科中的应用。 方法回顾性分析2008年11月至2015年10月在青岛市市立医院神经外科接受手术治疗的所有65岁以上老年三叉神经痛患者的临床资料，手术方式均为神经内镜辅助小切口微血管减压术。共62例，其中男28例，女34例。年龄65～83岁，平均72.6岁。病程9个月～22年，平均6.2年。 结果62例患者，术后55例（88.7%）疼痛消失，5例（8.1%）症状明显减轻，手术有效率96.8%。治疗有效中的60例获随访8～127个月，平均61个月。术后3年内复发3例，复发率4.8%。术后发生并发症8例。本组未出现与年龄相关的术后并发症，预后较好。 结论神经内镜结合小切口辅助三叉神经微血管减压术，有助于缩短手术时间，减少并发症，提高手术安全性和有效性，有助于老年患者术后加速康复。Objective To explore the value of neuroendoscope and minimal-access in enhanced recovery after surgery of microvascular decompression （MVD） for treatment elderly patients with idiopathic trigeminal neuralgia （ITN）. Methods The clinical data of 62 elderly patients with ITN who undergoing neuroendoscope-assisted minimal-access microvascular decompression were analyzed retrospectively, including operative data and follow-up results. Results In 62 cases, the effective rate was 96. 8% , with 88.7% complete cure and 8.1% little residual pain. Sixty successful cases were followed-up for an average of 61 months. Three cases recurred within 3 years after operation. Eight cases had complications after MVD. Conclusions There was no serious complications that could be ascribed to old age and the operative result was satisfactory compared with younger age cases. Endoscope and minimal-access can help shorten operation time, raise the effectiveness of MVD, reduce postoperative recurrence rate, and enhanced recovery after surgery for elderly patients.

关 键 词：神经内镜 外科手术 微创性 老年人 三叉神经痛 加速康复 

分 类 号：R651.3[医药卫生—外科学]