微血管减压术联合卡马西平在难治性三叉神经痛中的应用研究  

Application of microvascular decompression combined with carbamazepine in the treatment of refractory trigeminal neuralgia

作　　者：成振林 周勤仁 郑勇[2] 王斌 CHENG Zhenlin;ZHOU Qinren;ZHENG Yong;WANG Bin(Department of Neurosurgery,Zhangye People's Hospital Affiliated to Hexi University,Zhangye 734000,China;Department of Neurosurgery,Baoan District People's Hospital,Shenzhen 518101,China)

机构地区：[1]甘肃省河西学院附属张掖人民医院神经外科,734000 [2]广东省深圳市宝安区人民医院神经外科,518101

出　　处：《中华灾害救援医学》2019年第8期447-450,共4页Chinese Journal of Disaster Medicine

摘　　要：目的分析微血管减压术(microvascular decompression,MVD)联合卡马西平在难治性三叉神经痛(trigeminal neuralgia,TN)中的应用效果.方法回顾性总结2017-01至2018-06河西学院附属张掖人民医院神经外科诊断为难治性TN患者共80例,采用MVD联合卡马西平治疗,其中30例术中应用神经电生理监测(观察组),另50例根据术者经验判断减压效果(对照组).比较两组术后7 d疼痛视觉模拟评分(visual analogue scale,VAS)和围术期并发症,术后3个月临床效果和复发率.结果观察组术后7 d疼痛VAS评分(1.8±0.3)显著低于对照组(2.4±0.3),观察组并发症发生率(6.6%)低于对照组(24.0%),差异有统计学意义(P<0.05).观察组术后3个月临床效果优于对照组,随访复发率降低,差异有统计学意义(P<0.05).结论术中神经电生理监测评估MVD减压效果,联合卡马西平治疗难治性TN有较好的近期效果,可降低并发症和复发率,值得推广应用.Objective The objective of this study was to analyze the effect of microvascular decompression(MVD)combined with carbamazepine in the treatment of refractory trigeminal neuralgia(TN).Methods 80 patients with refractory TN diagnosed in the department of neurosurgery,Zhangye People's Hospital Affiliated to Hexi University from January 2017 to June 2018 were treated with MVD combined with carbamazepine.Among them,30 cases were treated with neuroelectrophysiological monitoring(observation group),and the other 50 cases were assessed the effect of decompression according to the experience of surgeons(control group).The pain visual analogue scale(VAS)score and perioperative complications were compared between the two groups 7 days after the operation and the clinical effect 3 months after the operation and the recurrence rate.Results The VAS score of pain in the observation group(1.8±0.3)was significantly lower than that in the control group(2.4±0.3)7 days after the operation,and the incidence of complications in the observation group(6.6%)was significantly lower than that in the control group(24.0%),and the differences were statistically significant(P<0.05).The clinical effect of the observation group was better than that of the control group 3 months after the operation,and the recurrence rate of follow-up was significantly lower than that of the control group,and the differences were statistically significant(P<0.05).Conclusions Intraoperative neuroelectrophysiological monitoring to evaluate the decompression effect of MVD combined with carbamazepine in the treatment of refractory TN has a good short-term effect and reduces the complications and recurrence rate.

关 键 词：微血管减压术 卡马西平 难治性三叉神经痛 神经电生理 小脑上动脉 

分 类 号：R4[医药卫生—临床医学]