经圆孔射频热凝上颌神经治疗三叉神经痛的临床观察  

CLINICAL OBSERVATION OF RADIOFREQUENCY THERMOCOAGULATION OF MAXILLARY NERVE FOR TRIGEMINAL NEURALGIA(II) THROUGH FORAMEN ROTUNDUM APPROACH

作　　者：杨娟[1] 高翃[1] 罗裕辉[1] 梁豪文[1] 李卓伦[1] 熊东林[1] 蒋劲[1] YANG Juan;GAO Hong;LUO Yu-Hui;LIANG Hao-Wen;LI Zhuo-Lun;XIONG Dong-Lin;JIANG Jin(Department of Pain Medicine, Shenzhen Nanshan People' s Hospital, Shenzhen 518052, China)

机构地区：[1]深圳市南山区人民医院疼痛科,深圳510052

出　　处：《中国疼痛医学杂志》2019年第5期357-360,共4页Chinese Journal of Pain Medicine

基　　金：国家临床重点专科建设项目资助;2015年度深圳市卫生计生系统科研项目(201506094)

摘　　要：目的:探讨经圆孔射频热凝上颌神经治疗三叉神经痛的安全性和疗效。方法:对40例第II支原发性三叉神经痛病人在X线下调整穿刺针的方向和深度至翼腭窝,穿刺圆孔并成功定位后,行温控射频热凝治疗。结果:40例病人均穿刺成功。其中38例病人术后第1天疼痛完全缓解伴颜面部第II支支配区麻木,无其他不良反应;2例术后疼痛有所减轻,发作频率及程度较术前明显减少。术后1月随访所有病人疼痛均完全消失,优良率100%。随访1年无复发。术后VAS评分与术前评估比较,有统计学意义(P <0.05)。结论:X线下经圆孔射频热凝上颌神经治疗原发性三叉神经痛定位准确、安全性和治疗效果良好。Objective: To investigate the safety and efficacy of radiofrequency thermocoagulation of maxillary nerve in treatment of trigeminal neuralgia through foramen rotundum approach. Methods: Forty patients with branch II idiopathic trigeminal neuralgia were involved. Under X-ray guidance, the puncture needles were regulated in direction and depth evaluation into foramen rotundum through Pterygopalatine Fossa and then were punctured to branch II trigeminal nerve for temperature-controlled radiofrequency therapy. Results: All the 40 patients were punctured smoothly. The complete pain relief was obtained in 38 patients with obvious facial numbness of branch II involved area on postoperative day 1, and no other serious complications were observed. Only 2 patients remained painful sensation after treatment, but the frequency and severity of painful episodes were significantly lower than before. All the patients had totally pain relief in 1 month follow-up, and the recovery rate for all the patients is 100%. No recurrence of pain was observed after 1 year follow-up. The average of postoperative VAS scores were statistically significant compared with the preoperative ones(P < 0.05). Conclusion: The application of X-ray guided radiofrequency thermocoagulation of maxillary nerve in treatment of idiopathic trigeminal neuralgia through foramen rotundum approach is accurate, safe, and effective to treat branch II idiopathic trigeminal neuralgia.

关 键 词：射频热凝术 原发性三叉神经痛 翼腭窝 圆孔 

分 类 号：R745.11[医药卫生—神经病学与精神病学]