神经梳理术治疗非血管压迫型三叉神经痛的临床分析  

Nerve combing for trigeminal neuralgia without vascular compression

作　　者：杨德宝[1] 周世军[1] 王之敏[1] 

机构地区：[1]苏州大学附属第三医院上海交通大学医学院附属苏州九龙医院神经外科,苏州215021

出　　处：《中华神经医学杂志》2018年第1期95-98,共4页Chinese Journal of Neuromedicine

基　　金：苏州市“科教兴卫”青年科技项目（KJXW2016072）

摘　　要：目的探讨神经梳理术治疗非血管压迫型三叉神经痛的效果及安全性。方法回顾性分析自2008年1月至2016年1月苏州九龙医院神经外科收治的281例三叉神经痛患者的临床资料，其中利用神经梳理术治疗非血管压迫型三叉神经痛患者32例，归为A组；利用显微血管减压术治疗三叉神经痛患者249例，归为B组；对比2组患者手术效果和术后并发症。结果A组术后治愈率为90．6％（29／32）；平均随访62．5个月后，治愈率为78．1％（25／32）。B组术后治愈率为94．4％（235／249）；平均随访59．8个月后，治愈率为84．1％（201／239）。2组患者术后及远期效果差异均无统计学意义（P〉0．05）。2组患者均无严重致残以及致死的术后并发症。A组面部麻木发生率（71．9％）显著高于B组（2．5%），差异有统计学意义（P〈0．05）。结论神经梳理术治疗非血管压迫型三叉神经痛安全有效．面部麻木是其主要并发症。Objective To evaluate the efficacy and safety of nerve combing for trigeminal neuralgia without neurovascular decompression. Methods A retrospective review of clinical data of 281 patients with trigeminal neuralgia, admitted to our hospital from January 2008 to January 2016, was performed. The patients were divided into two groups： patients from group A were treated by nerve combing （n=32）, and patients from group B were treated by microvascular decompression （n=249）. The two groups were compared in terms of surgical outcomes and postoperative complications. Results The pain was completely relieved in 90.6% patients of group A （29/32） and 94.4% patients of group B （235/249）, respectively; the mean follow-up duration was 62.5 months in group A, and 78.1% patients （25/32） were completely relieved; the mean follow-up duration was 59.8 months in group B, and 84.1% patients （201/239）were completely relieved; no statistically significant differences existed in the surgical outcomes and long-term outcomes between the two groups （P〉0.05）. No complications related to severe disability or death were noted in the two groups. The rate of facial numbness in patients from group A （71.9%） was significant higher than that in group B （2.5%, P〈0.05）. Conclusions Nerve combing is a safe and effective treatment for trigeminal neuralgia without neurovascular decompression. Most patients treated with nerve combing experienced some degrees of facial numbness.

关 键 词：三叉神经痛 神经梳理术 显微血管减压术 血管压迫 

分 类 号：R745.11[医药卫生—神经病学与精神病学]