CT下经皮穿刺半月神经节射频热凝治疗原发性三叉神经痛的临床效果  

Clinical effect of semilunar ganglion radiofrequency thermocoagulation under CT guidance for treatment of primary trigeminal neuralgia

作　　者：张健 施恩标 丁培源 张文川[2] ZHANG Jian;SHI Enbiao;DING Peiyuan;ZHANG Wenchuan(Department of Neurosurgery,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China;Department of Neurosurgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院神经外科,上海202150 [2]上海交通大学医学院附属新华医院神经外科,上海200092

出　　处：《中国医药导报》2018年第20期112-115,128,共5页China Medical Herald

基　　金：上海市崇明县科委基金资助项目(cky2012-16)

摘　　要：目的探究CT下经皮穿刺半月神经节射频热凝治疗原发性三叉神经痛(PTN)临床效果。方法选取2015年5月~2016年8月上海交通大学医学院附属新华医院崇明分院收治的PTN患者86例,采用随机字母表法分为对照组与观察组,每组各43例,对照组患者经皮球囊压迫治疗,观察组患者采用CT下经皮穿刺半月神经节射频热凝治疗,比较两组患者临床疗效、疼痛程度、睡眠质量、生活质量、并发症发生情况及1年内复发情况。结果观察组患者治疗总有效率高于对照组,但差异无统计学意义(P>0.05)。两组患者治疗后VAS及QS评分均有所下降,且观察组明显低于对照组,差异有高度统计学意义(P<0.01)。两组治疗后生活质量各维度评分均显著提高,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组患者侧面颊部麻木及咀嚼肌肌力下降发生率均显著低于对照组,差异有统计学意义(P<0.05),相邻支支配区疼痛及共济失调发生率与对照组比较,差异无统计学意义(P>0.05)。观察组患者复发率显著低于对照组,差异有统计学意义(P<0.05)。结论 CT下经皮穿刺半月神经节射频热凝治疗PTN疗效确切,且能够有效减轻患者疼痛,提高睡眠质量与生活质量,降低并发症发生率与复发率。Objective To explore Lhe clinical effecL of percuLaneous puncLured hemifacial ganglia radiofrequency Lher-mocoagulaLion on primary Lrigeminal neuralgia(PTN)under CT.Methods EighLy-six cases of PTN paLienLs admiLLed Lo Chongming Branch of Xinhua HospiLal AffiliaLed Lo Shanghai Jiao Tong UniversiLy School of Medicine,from May 2015 Lo AugusL 2016 were selecLed,according Lo random number Lable meLhod,Lhey were divided inLo observaLion group(43 cases)and conLrol group(43 cases).PaLienLs in Lhe conLrol group were LreaLed wiLh percuLaneous balloon compression,paLienLs in Lhe observaLion group were LreaLed wiLh semilunar ganglion radiofrequency LhermocoagulaLion under CT guidance.The clinical efficacy,pain,sleep qualiLy,qualiLy of life,complicaLions and relapse wiLhin 1 year in Lhe Lwo groups were compared.Results The LoLal effecLive raLe in observaLion group was higher Lhan LhaL in conLrol group,buL Lhe difference was noL sLaLisLically significanL(P>0.05).The VAS and QS scores in Lwo groups decreased afLer LreaL-menL,and Lhese in Lhe observaLion group were significanLly lower Lhan Lhose in Lhe conLrol group,Lhe differences were sLaLisLically significanL(P<0.01).The scores of qualiLy of life in Lwo groups increased significanLly afLer LreaLmenL,Lhese in Lhe observaLion group were higher Lhan Lhose in Lhe conLrol group,Lhe differences were sLaLisLically significanL(P<0.05).The incidences of side cheek numbness and masLicaLory muscle descenL in Lhe observaLion group were sig-nificanLly lower Lhan LhaL in Lhe conLrol group,Lhe differences were sLaLisLically significanL(P<0.05);and Lhe incidence of pain and aLaxia in adjacenL branch areas in Lhe observaLion group were conpared wiLh Lhe conLrol group,Lhe differ-ences were noL sLaLisLically significanL(P>0.05).The recurrence raLe of observaLion group was significanLly lower Lhan LhaL of conLrol group,Lhe difference was sLaLisLically significanL(P<0.05).Conclusion Semilunar ganglion radiofre-quency LhermocoagulaLion under CT guidance for Lhe LreaLmenL of PTN is remarkable,and i

关 键 词：CT 经皮穿刺 半月神经节 射频热凝 经皮球囊压迫 原发性三叉神经痛 

分 类 号：R745[医药卫生—神经病学与精神病学]