不同显微神经外科手术治疗原发性三叉神经痛临床疗效分析  

Clinical Efficacy Analysis of Different Microsurgical Neurosurgery Treatment of Idiopathic Trigeminal Neuralgia

作　　者：李舜[1] 唐晓平[1] 王远传[1] 段劼[1] 张涛[1] 苟章洋[1] 印晓鸿[1] 漆建[1] 罗仁国[1] 

机构地区：[1]川北医学院附属医院神经外科,四川南充637000

出　　处：《系统医学》2016年第11期1-3,13,共4页Systems Medicine

基　　金：南充市科技局项目(编号:14A0040)

摘　　要：目的探讨研究不同显微神经外科手术治疗原发性三叉神经痛的临床疗效。方法选取在该院自2008年2月—2015年6月时间段内接受治疗的原发性三叉神经痛患者72例,进行回顾性分析,根据是否存在责任血管压迫神经,采取不同的手术方案,研究分为微血管减压手术组(microvasculardecompression,MVD)50例和三叉神经部分感觉根切断手术组(partialsensoryrhizotomy,PSR)22例,观察患者术后的临床疗效。结果 MVD组有效率为94%,PSR组有效率为90.9%,组间有效率对比,P>0.05,差异无统计学意义;术后1年进行随访,MVD组、PSR组复发率分别为22.0%、0%,组间比较,差异有统计学意义。结论针对原发性三叉神经痛患者,术前应充分评估病情,完善相关检查,明确有无责任血管压迫神经,从而选取不同的手术方案,MVD法、PSR法均有较好的近期临床疗效,但采取PSR法治疗的患者复发率更低,采取MVD法不良反应发生较少,预后较好。Objective To evaluate the clinical efficacy of different neurosurgery surgical treatment of trigeminal neuralgia. Methods In our hospital receiving treatment from February 2008 to June 2015 period in 72 patients with primary trigeminal neuralgia were retrospectively analyzed, according to the presence or absence of offending vessels nerve to take a different surgical options Research into microvascular decompression surgery group（microvasculardecompression,MVD） 50 cases and trigeminal sensory root partial amputation group（partialsensoryrhizotomy, PSR） 22 cases observed clinical effect in patients with surgery. Results MVD group was 94%, PSR group was 90.9%, efficiency comparison between the two groups, P 0.05, the difference was not statistically significant; after 1 year follow-up, MVD group, PSR relapse rate 22.0%, 0%, between the two groups, the difference was statistically significant. Conclusion For patients with primary trigeminal neuralgia, preoperative should fully assess the condition, perfect the relevant inspection, have clearly without responsibility oppressive nerve, blood vessel to select different operation schemes, MVD, PSR has good recent clinical curative effect, but take the PSR treatments for patients with lower recurrence rate, adopt method of MVD adverse reactions happen less prognosis is good.

关 键 词：三叉神经痛 微血管减压术 部分感觉根切断术 疗效 

分 类 号：R651[医药卫生—外科学]