大样本三叉神经半月节射频热凝术的长期疗效及安全性研究  

Long-term Efficacy and Safety of a large sample of Trigeminal Ganglion Radiofrequency Thermocoagulation

作　　者：曹昭 李宁[1] 李秀华[2] 何亮亮[2] 倪家骧[2] CAO Zhao;LI Ning;LI Xiu-hua;HE Liang-liang(Weifang Medical University,Shandong Weifang 261053,China;Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]潍坊医学院麻醉学系,山东潍坊261053 [2]首都医科大学宣武医院疼痛诊疗中心,北京100053

出　　处：《临床医药文献电子杂志》2018年第7期7-9,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的研究CT或C型臂引导下经卵圆孔三叉神经半月节选择性射频热凝治疗三叉神经痛的长期疗效及并发症发生情况。方法本研究回顾性分析1605例曾行射频热凝治疗原发性三叉神经痛的病例,术中采用CT或C型臂靶向定位三叉神经半月节,控制热凝温度60~75℃,连续热凝时间30~60 s。观察其近、远期疗效并总结分析并发症。结果射频热凝术后即时有效率91.09%,其中优良1320例(82.24%)、显效142例(8.85%)、无效143例(8.91%),术后随访10年内有效率均高于50%。射频热凝术及其他术式后复发的患者再行射频手术的有效率为88.45%。常见并发症有面部麻木(92.15%)、咀嚼肌力减退(8.97%)、眼睛干涩(3.86%)等。结论本手术方法安全有效,并且对微血管减压术(MVD)复发或无效、以及射频热凝术单次或多次复发的三叉神经痛患者仍然存在良好的治疗效果。Objective To analyze the long-term clinical effect and complications of selective trigeminal ganglion radiofrequency thermocoagulation via oval foramen guided by CT or C-arm to treat trigeminal neuralgia.Methods This study retrospectively analyzes 1605 cases of primary trigeminal neuralgia treated with radiofrequency thermocoagulation to observe the short and long term clinical effect,to summarize and analyze the complications.The trigeminal ganglion was targeted by CT or C arm during the operation.The temperature of thermocoagulation was controlled at 60~75℃and the continuous thermocoagulation time was controlled at 30~60 s.Results The immediate effective rate of radiofrequency thermocoagulation was 91.09%,of which 1320 cases had excellent effect(82.24%),142 cases had evident effect(8.85%)and 143 cases had ineffective(8.91%).The effective rates in 10 years follow-up were all higher than 50%.The effective rate of the patients with recurrence after radiofrequency thermocoagulation and other operations was 88.45%.The immediate effective rate of trigeminal ganglion radiofrequency thermocoagulation in the treatment of recurrent trigeminal neuralgia after other surgical treatment.Compared with the first radiofrequency surgery,the difference was not statistically significant.The common complications were facial numbness(92.15%)and masseter weakness(8.97%)and dry eyes(3.86%).Conclusion Trigeminal ganglion radiofrequency thermocoagulation is safe and effective.It has a good therapeutic effect in the treatment of the recurrence after microvascular decompression(MVD).It is also worthy of the patients with single or multiple recurrent trigeminal neuralgia.

关 键 词：CT或C型臂 三叉神经痛 射频 并发症 

分 类 号：R745.11[医药卫生—神经病学与精神病学]