三叉神经感觉根梳理术治疗特殊类型三叉神经痛的处理策略  

The application of the internal neurolysis for special type of trigeminal neuralgia: management strategy

作　　者：姜晓峰 牛朝诗 傅先明 计颖 丁宛海 汪业汉 JIANG Xiaofeng;NIU Chaoshi;FU Xianming;JI Ying;DING Wanhai;WANG Yehan(Department of Neurosurgery, The First Affiliated Hospital of University of Science and Technology of China （AnhuiProvincial Hospital）, Anhui Key Laboratory of Brain Function and Disease, Hefei 230036, Chin)

机构地区：[1]中国科技大学附属第一医院(安徽省立医院)神经外科脑功能与脑疾病安徽省重点实验室,安徽合肥230036

出　　处：《中华神经外科疾病研究杂志》2018年第3期241-244,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：脑功能与脑疾病安徽省重点实验室绩效考核补助项目(1606c08235)

摘　　要：目的探讨应用三叉神经感觉根梳理术治疗特殊类型三叉神经痛的选择策略、手术技巧及体会。方法对35例特殊类型三叉神经痛进行术中探查,其中12例无责任血管类型、8例静脉无法减压类型以及5例复发类型选择单纯三叉神经感觉根梳理术;10例责任血管不确定类型(5例小脑上动脉、1例小脑前下动脉、4例静脉)选择三叉神经感觉根梳理联合显微血管减压术。结果 35例患者术后疼痛均消失,均遗留有面部中度麻木,痛、温、触觉大部分存在,门诊平均随访3年,均无复发。结论针对显微血管减压术中无责任血管类型、静脉无法减压类型、复发类型以及责任血管不确定类型,单纯或者联合三叉神经感觉根梳理术不仅能够有效解除疼痛,而且较感觉根部分切断术而言对神经损害小,功能障碍程度低,疗效满意。Objective The strategy and skills of internal neurolysis as a treatment for special type of trigeminal neuralgia were explored.Methods In 35 patients （12 cases without neurovascular compression,8 cases of venous pressure,5 cases of recurrent cases,10 cases of uncertain of conflict vessel） with special type trigeminal neuralgia received internal neurolysis,the safety,efficacy,and durability of internal neurolysis were evaluated.Results All the patients had a complete pain relief and a moderate facial numbness,and no recurrence was observed during an average 3 years＇fllow-up.Conclusion Internal neurolysis is a safe,effective,and durable treatment for TN in the special type.Pain-free outcomes with internal neurolysis appear to be less injury and better results compared with sensory rhizotomy.

关 键 词：梳理 三叉神经痛 无血管 静脉 复发 

分 类 号：R741.05[医药卫生—神经病学与精神病学]