不同靶目标穿刺射频热凝术治疗上颌神经痛的临床对照研究  

Clinical control study of maxillary neuralgia treated with percutaneous foramen rotundum and foramen ovale radiofrequency thermocoagulation

作　　者：杨巨顺[1] 崔磊[1] 王祥 何玉泉[1] 龚沈初 何书[3] 张树清[1] 吴献华[4] 尹剑兵[1] Yang Jushun Cui Lei Wang Xiang He Yuquan Gong Shenchu He Shu Zhang Shuqing Wu Xianhua Yin Jianbin(Department of Radiology, Second Affiliated Hospital of Nantong University, Nantong 226001, China Department of Stomatology, Second Affiliated Hospital of Nantong University, Nantong 226001, China Department of Health Statistics, Nantong University, Nantong 226001, China Department of Radiology, Affiliated Hospital of Nantong University, Nantonz 226019, China)

机构地区：[1]南通大学第二附属医院影像科,南通226001 [2]南通大学第二附属医院口腔科,南通226001 [3]南通大学统计教研室,南通226001 [4]南通大学附属医院影像科,南通226019 [5]不详

出　　处：《中华神经医学杂志》2017年第10期1046-1051,共6页Chinese Journal of Neuromedicine

摘　　要：目的比较经皮穿刺圆孔、卵圆孔射频热凝术（PRT）治疗上颌神经痛的临床疗效。方法选择南通大学第二附属医院口腔科自2010年3月至2014年12月收治的原发性三叉神经上颌神经支疼痛患者80例，使用密闭信封法将患者分为卵圆孔组和圆孔组，每组40例。卵圆孔组患者经皮穿刺卵圆孔行PRT，圆孔组患者经翼腭窝穿刺圆孔行PRT。记录术前、术后1周、1个月、3个月、6个月、12个月时患者的视觉模拟评分（VAS）及患者的穿刺时间、手术副反应、并发症。术后1周、1个月、3个月、6个月、12个月评价患者的疗效，计算术后优良率及复发率。结果卵圆孔组患者的穿刺时间明显短于圆孔组，但并发症（V1、V3支受累）的发生率高于圆孔组，差异有统计学意义（P〈0.05）；2组患者各时间点VAS评分比较差异均无统计学意义（P〉0.05）；术后3个月、6个月、1年，卵圆孔组患者的复发率分别为5.1%（2/39）、7.8%（3/39）、15.4%（6/39），圆孔组患者的复发率分别为2.8%（1/36）、11.1%（4/36）、11.1%（4/36），比较差异均无统计学意义（P〉0.05）。术后1周、3个月、6个月、1年，2组患者的优良率比较差异均无统计学意义（P〉0.05）。结论经皮穿刺卵圆孔、圆孔行PRT治疗上颌神经痛均安全、有效，但经圆孔入路的手术并发症少于卵圆孔入路。ObjectiveTo compare the clinical effects of percutaneous foramen rotundum and percutaneous foramen ovale radiofrequency thermocoagulation （PRT） on maxillary neuralgia.MethodsEighty patients with primary maxillary neuralgia were randomly divided into puncture foramen （group A） and foramen rotundum through pterygopalatine fossa （group B）. Visual analogue scale （VAS） scores, puncture time, surgical side effects, and complications were recorded before surgery, one week, and one, 3, 6 and 12 months after operation. Recurrent rate and excellent and good results were calculated one week, and one, 3, 6 and 12 months after operation.ResultsThe operation time of group A was significantly shorter than that of group B （P〈0.05）, however, complications （involved V1 and V3 branches） of group A were significantly higher than those of group B （P〈0.05）. VAS scores of two groups showed no significant differences at each time points （P〉0.05）. Recurrence rate of group A 3, 6 and 12 months after surgery was 5.1%（2/39）, 7.8%（3/39） and 15.4%（6/39）, respectively, which showed no significant differences as compared with that of group B （2.8%[1/36], 11.1%[4/36] and 11.1%[4/36], P〉 0.05）. Rate excellent and good results showed no significant differences between each two groups one week, and 3, 6 and 12 months after operation （P〉0.05）.ConclusionPercutaneous punctures of the foramen ovale and foramen rotundum approach radiofrequency thermocoagulation for the treatment of maxillary neuralgia are safe and effective operation methods; surgical complications in foramen rotundum approach are less than those in the foramen ovale approach.

关 键 词：圆孔 卵圆孔 上颌神经痛 射频热凝术 

分 类 号：R745[医药卫生—神经病学与精神病学]