205例半月神经节射频热凝治疗原发性三叉神经痛的疗效分析  

PERCUTANEOUS RADIOFREQUENCY THERMOCOAGULATION OF GASSERIAN GANGLION FOR TRIGEMINAL NEURALGIA: EXPERIENCE IN 205 PATIENTS

作　　者：郭金婉 张建中 宋文阁[1] 傅志俭[1] 赵学军[1] 孙涛[1] 赵序利[1,2] GUO Jin-Wan;ZHANG Jian-zhong;SONG Wen-Ge;FU Zhi-Jian;ZHAO Xue-Jun;SUN Tao;ZHAO Xu-Li(Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,China;Dongying People's Hospital,Dongying,257000,China)

机构地区：[1]山东大学附属省立医院疼痛科,济南250021 [2]东营市人民医院,东营257000

出　　处：《中国疼痛医学杂志》2018年第8期597-602,共6页Chinese Journal of Pain Medicine

基　　金：山东省中青年科学家奖励基金(BS2013YY047);中国博士后基金(2014M551922)

摘　　要：目的:探讨半月神经节射频热凝治疗原发性三叉神经痛(trigeminal neuralgia,TN)的效果。方法:205例TN病人在我院疼痛科接受半月神经节射频热凝治疗(percutaneous radiofrequency thermocoagulation,PRT),从其医疗记录及2014年5月的问卷调查中统计术后效果,疼痛缓解持续时间,复发率和并发症。通过Kaplan Meier进行分析评估。所有病人均随访至少5个月。结果:两人失访,剩余203人术后有效率(治愈及好转)为91.13%(186/203),总复发率为13.79%(28/203)。151例病人出现术后患侧面部麻木;20例出现角膜炎;8例出现咬肌无力;1例并发耳鸣,1例术后恶心呕吐。所有并发症均在3个月内恢复,无明显神经系统后遗症。结论:半月神经节PRT是治疗原发性TN的有效方法。病人术后可出现各种并发症,尤其应注意预防眼部并发症。Objective:To evaluate the long-term outcomes of Percutaneous Radiofrequency Thermocoagulation(PRT)for idiopathic Trigeminal neuralgia(TN).Methods:Two hundred and five patients suffering from idiopathic TN received PRT of gasserian ganglion in department of pain medicine.Immediate outcomes,duration of pain-free,recurrence rate and complications were obtained from their medical records and questionnaires sent in May 2014.The obtained data was assessed by survival analysis.All patients were followed-up at least 5 months.Results:Two patients were lost to follow up.The immediate postoperative effective rate(excellent and good)was 91.13%(186/203).Total recurrence rate was 13.79%(28/203).151 patients suffered hypoesthesia and numbness,of which 20 with keratitis,8 with motor weakness of the masseter muscle,6 with mild prosopoplegia,1 with tinnitus,and 1 with vomiting after surgery.These complications were recovered within 3 months,without serious neurological sequelae.Conclusion:These results indicate that PRT of gasserian ganglion is an effective method to treat idiopathic TN,while more attention should be paid to the complications,especially to ocular complications.

关 键 词：半月神经节 射频热凝 三叉神经痛 

分 类 号：R745.11[医药卫生—神经病学与精神病学]