经颌下-卵圆孔入路穿刺射频热凝治疗三叉神经痛  

Radiofrequnency thermocoagulation via puncture for primary trigeminal neuralgia

作　　者：朱浩[1] 华泽权[1] 薛聪聪[1] 张力[1] ZHU Hao;HUA Ze-quan;XUE Cong-cong;ZHANG Li(Department of Stomatology,Shenyang General Hospital,PLA,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院口腔科,沈阳110016

出　　处：《中国临床神经外科杂志》2018年第7期482-483,509,共3页Chinese Journal of Clinical Neurosurgery

基　　金：辽宁省自然科学基金(201602803)

摘　　要：目的探讨经颌下-卵圆孔入路穿刺射频热凝治疗三叉神经第Ⅲ支病变导致的原发性三叉神经痛的可行性和有效性。方法 2016年1月至2017年4月收治三叉神经第Ⅲ支病变导致的原发性三叉神经痛40例,采用经颌下-卵圆孔入路20例,采用Hartel前入路20例。两组均在三维CT定位下穿刺卵圆孔,定位成功后,行温控射频热凝治疗。结果两组术后各有1例治疗无效,有效率均为95%,未见严重的并发症和其他神经损伤。两组手术时间大致相同(P>0.05)。术后6个月随访,疼痛缓解效果相同(P>0.05)。结论三维CT定位下,经颌下-卵圆孔入路方法治疗三叉神经第Ⅲ支病变导致的原发性三叉神经痛具有可行性和有效性,并且可弥补Hartel前入路方法的局限。Objective To explore the feasibility and outcomes of radiofrequnency thermocoagulation via puncture for primary trigeminal neuralgia.Methods Forty patients with isolated classical third branch(V3)trigeminal neuralgia were randomly divided into submandibullar region and foramen ovale approach group(n=20)and conventional Hartel's approach group(n=20).The Gasserian ganglia through the foramen ovale were punctured and the radiofrequency thermocoagulation were performed after the trigger point of the neuralgia was accurately positioned in both the groups.Procedure details and the primary clinical outcomes and postoperative complication were compared between both the groups and analyzed.Results The neuralgia was unchanged in one patient of every group after the operation.The efficiency rates were all 95%and no serious complications occurred in both the groups.The following-up 6 months after treatment showed that the relief effect on pain is the same in both the groups.Conclusions The percutaneous radiofrequency thermocoagulation through submandibullar region and foramen ovale approach is practicable and its curative effect on the trigeminal neuralgia is good.

关 键 词：原发性三叉神经痛 射频温控热凝术 经颌下-卵圆孔入路 Hartel前入路 

分 类 号：R745.11[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]