CT引导下三叉神经射频热凝手术感觉神经定量检测的疗效评价  

APPLICATION OF CURRENT PERCEPTION THRESHOLD IN CT-GUIDED TRIGEMINAL RADIOFREQUENCY COAGULATION SURGERY

作　　者：刘倩影 倪华栋[1] 陈雅静 姚明[1] 周煦燕[1] 黄冰[1] 安康 朱春燕 和秋莉 LIU Qian-Ying;NI Hua-Dong;CHEN Ya-Jing;YAO Ming;ZHOU Xu-Yan;HUANG Bing;AN Kang;ZHU Chun-Yan;HE Qiu-Li(Department of Anesthesiology and Pain Medical Center,the First Affiliated Hospital of Jiaxing University,Jiaxing 314000,China;Bengbu Medical College Graduate Department,Bengbu 233030,China)

机构地区：[1]嘉兴学院附属第一医院疼痛科,嘉兴314000 [2]蚌埠医学院研究生院,蚌埠233030

出　　处：《中国疼痛医学杂志》2019年第12期898-902,共5页Chinese Journal of Pain Medicine

基　　金：浙江省自然科学基金(LY20H090020);嘉兴市科技计划(2018AY32012);浙江省医药卫生计划(2020358554,2019KY687);浙江省市共建重点学科-疼痛医学

摘　　要：目的:总结感觉神经定量检测仪(current perception threshold,CPT)在三叉神经损毁射频热凝手术前后的应用,定量评估损毁射频热凝术对三叉神经切断的临床效果。方法:收集并分析嘉兴市第一医院2017年2月至2017年8月期间进行CT引导下三叉神经损毁射频热凝术治疗三叉神经痛的病人30例,比较术前术后患侧CPT值的变化,并于术后对病人进行随访。结果:30例病人在术前1天进行了患侧CPT的测试。术后1天再次对患侧进行CPT测试。根据巴罗神经学研究所分级标准,将所有病人分为两组,若病人术后分级为优或良,纳入手术显效组,术后分级为差,纳入手术无效组。术后23人纳入手术显效组,7人纳入手术无效组。对两组内术前术后CPT数值采取配对t检验进行数据处理,两组间术前CPT数值采取独立样本t检验。在手术显效组内,患侧术后CPT数值升高,差异有统计学意义(P<0.05),而在手术无效组内,部分病人术后CPT有所升高,但组内差异无统计学意义。两组术前CPT数值比较,差异有统计学意义(P<0.05)。结论:CPT对评估病人的感觉功能有一定的意义,在三叉神经损毁射频热凝术的应用中可以在术前对三叉神经的病变程度起到一定的评估作用,并对预测手术效果,定量评估手术效果有一定的临床参考价值。Objective:To summarize the application of current perception threshold(CPT),CPT before and after radiofrequency coagulation for treating,and quantitatively evaluating the clinical effect of radiofrequency thermocoagulation on trigeminal neuralgia.Methods:We collected and analyzed 30 trigeminal neuralgia patients undergoing trigeminal radiofrequency coagulation with CT(computed tomography)-guidance from February 2017 to August 2017 in Jiaxing First Hospital.The preoperative and postoperative changes in CPT values were compared,and patients were followed up after surgery.Results:Thirty patients were treated with ipsilateral CPT test 1 day before and after surgery.According to the classification criteria of the Barrow Neurological Institute,all patients were divided into two groups:if the patients were graded as excellent or good after surgery,they were included in the effective group,and the others were included in the ineffective group.Totally,23 patients were included in the effective group and 7 patients were included in the ineffective group.Paired t-tests were performed on the CPT values of the two groups for data processing.Preoperative CPT values between two groups were calculated as independent sample t-tests.In the effective group,the CPT value of the ipsilateral side increased significantly(P<0.05),but in the ineffective group,some patients had elevated CPT after surgery,but the differences within the group were not statistically significant.The difference of pre-operative CPT between the two groups was statistically significant(P<0.05).Conclusion:CPT is effective in evaluating the patient's sensory function.In the application of trigeminal radiofrequency thermocoagulation,the degree of lesions of the trigeminal nerve can be evaluated before surgery that has clinical reference value for predicting the effect of surgery and quantitatively evaluating the effect of surgery.

关 键 词：三叉神经 射频热凝 感觉神经定量检测仪 

分 类 号：R651.3[医药卫生—外科学] R816.1[医药卫生—临床医学]