三叉神经痛微血管减压术后皮下积液的防治研究  

Prevention and Treatment of Subcutaneous Fluid Accumulation after Microvascular Decompression of Trigeminal Neuralgia

作　　者：江楠 蔡丹辉 黄敏东 陈曼华 黄嘉斌 林金逢 JIANG Nan;CAI Dan-hui;HUANG Min-dong;CHEN Man-hua;HUANG Jia-bin;LIN Jin-feng(Department of Neurology,Section Two,Jieyang People＇s Hospital（Jieyang Hospital Affiliated to Sun Yat-sen University）,Jieyang,Guangdong Province,522000 China)

机构地区：[1]揭阳市人民医院(中山大学附属揭阳医院)神经外二科,广东揭阳522000

出　　处：《中外医疗》2018年第19期56-57,60,共3页China & Foreign Medical Treatment

摘　　要：目的通过技术改进,防治患者在三叉神经痛微血管减压术后发生皮下积液等并发症。方法回顾性分析该院神经外二科2016年3—9月手术治疗的三叉神经痛患者9例。通过寻找人体的解剖标志,在满足手术暴露的前提下,辅助设计小切口和微骨窗,显露横窦乙状窦转角,弧形剪开硬膜,按常规操作行微血管减压术后,取一4 cm×4 cm免缝人工硬膜置于硬膜切口下,缝合硬膜。将骨瓣复位并固定,分层缝合头皮。观察和分析其临床效果及并发症情况。结果实验组与对照组的术后效果有明显的差异,术后实验组所有9例患者发作性疼痛即刻消失,均于术后6 d拆线出院。无皮下积液、切口感染、脑脊液漏等并发症。随访3~12个月,无疼痛复发,无患者需要再次服药。结论通过开颅和关颅阶段的技术改进,能有效预防术后皮下积液等并发症发生,手术更微创,效果更好。Objective Through technical improvements, it prevents complications such as subcutaneous effusion after microvascular decompression of trigeminal neuralgia. Methods 9 patients with trigeminal neuralgia undergoing surgical treatment from March to September 2016 were retrospectively analyzed. Through the search for anatomical landmarks of the human body, under the premise of satisfying the surgical exposure, assist the design of small incisions and microfractures to expose the sigmoid sinus angles of the transverse sinus, cut the dura by arc, and perform microvascular decompression after routine operation. A 4 cm ×4 cm seamless artificial dura mater was placed under the dural incision and the dura was sutured. The bone flap was repositioned and fixed and the scalp was sutured. Observe and analyze the clinical effects and complications. Results The postoperative effects of the experimental group and the control group were significantly different.All nine patients in the postoperative group experienced immediate paroxysmal pain and were discharged from the hospital6 d after the operation. No complications such as subcutaneous effusion, incision infection, and cerebrospinal fluid leakage.Follow-up from 3 months to 12 months, no pain recurrence, no patients need to take the drug again. Conclusion Through the technical improvement of the craniotomy and cranial phase, it can effectively prevent the occurrence of postoperative complications such as subcutaneous effusion, and the operation is more minimally invasive and has a better effect.

关 键 词：微血管减压术 三叉神经 皮下积液 骨瓣成形 

分 类 号：R745.11[医药卫生—神经病学与精神病学]