神经血管减压术治疗偏头痛的临床研究  

Clinical study of neurovascular decompression for migraine

作　　者：周庆明[1] 潘海鹏[1] 金永健 郝亚光 ZHOU Qing-ming;PAN Hai-peng;Jin Yongjian(Aviation General Hospital,Beijing 100012,China)

机构地区：[1]航空总医院,100012

出　　处：《中国实用医药》2020年第26期31-34,共4页China Practical Medicine

摘　　要：目的探讨神经血管减压术治疗偏头痛的临床效果。方法181例偏头痛患者,随机分为观察组(89例)和对照组(92例)。两组患者均行神经血管减压术治疗。对照组术前行头颅磁共振成像(MRI)及磁共振血管造影(MRA)检查,排查有无颅内器质性病变及脑血管病;心脏超声检查及发泡观察排查有无卵圆孔未闭;术前采用视觉模拟评分法(VAS)进行疼痛评分;术后6个月随访并行VAS疼痛评分。观察组在对照组相关检查的基础上,术前对患者进行头痛影响测定-6(HIT-6)测定;偏头痛残疾程度评估问卷(MIDAS)评估;请心身医学科医师评估心理状态,排除心理疾患;出院前再次行VAS疼痛评分;术后1、3、6个月分别进行随访,并行VAS疼痛评分。比较两组患者的治疗效果。结果观察组总有效率为88.76%(79/89),高于对照组的76.09%(70/92),差异有统计学意义(P<0.05)。结论神经血管减压术能够有效治疗偏头痛,但手术的选择一定要严格掌握适应证,术后加强随访并关注患者的心理状态,进行积极有效的沟通,能够明显提升治愈率,改善预后。Objective To discuss the clinical effect of neurovascular decompression for migraine.Methods A total of 181 cases of migraine patients were randomly divided into observation group(89 cases)and control group(92 cases).Both groups were treated with neurovascular decompression.The control group underwent head magnetic resonance imaging(MRI)and magnetic resonance angiography(MRA)before operation to check for intracranial organic diseases and cerebrovascular diseases,echocardiography and foam observation were performed to check for patent foramen ovale,and visual analogue scale(VAS)was used to evaluate pain before operation and 6 months after operation.On the basis of the control group,the observation group underwent headache impact test-6(HIT-6)before operation and migraine disability assessment scale(MIDAS)evaluation,and psychosomatic physicians were invited to evaluate their mental status and exclude psychology illness;VAS pain score was performed again before discharge;follow-up was performed 1,3,and 6 months after operation,and VAS pain score was also performed.The therapeutic effect of the two groups was compared.Results The total effective rate of the observation group was 88.76%(79/89),which was higher than that of the control group 76.09%(70/92),and the difference was statistically significant(P<0.05).Conclusion Neurovascular decompression is effective in treating migraine,but the indications must be strictly controlled.Enhancing follow-up and paying attention to the patient's psychological state after the operation along with active and effective communication can significantly increase the cure rate and improve the prognosis.

关 键 词：神经血管减压术 偏头痛 心理因素 

分 类 号：R651.11[医药卫生—外科学]