伽玛刀放射治疗原发性三叉神经痛的长期随访分析  

Long-term follow-up analysis of gamma knife surgery for primary trigeminal neuralgia

作　　者：王亮亮[1] 顿志平[1] 张铭 孙振伟 王成伟[1] 樊跃飞 Wang Liangliang;Dun Zhiping;Zhang Ming;Sun Zhenwei;Wang Chengwei;Fan Yuefei(Department of Neurosurgery,The Second Hospital of Shandong University,Ji’nan 250033,China)

机构地区：[1]山东大学第二医院神经外科,济南25033

出　　处：《中华脑科疾病与康复杂志（电子版）》2020年第5期267-271,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的总结分析伽玛刀(GKS)治疗原发性三叉神经痛(PTN)的手术经验。方法回顾性分析山东大学第二医院神经外科自2016年5月至2019年12月经GKS治疗的53例PTN患者的临床资料,评估疗效、安全性及影响预后的因素。结果伽玛刀术后疼痛缓解的起效时间约为35(7.5,85)d,疼痛缓解率为90.57%。伽玛刀治疗术后BNI分级比术前BNI分级明显改善,其差异具有统计学意义(Z=-5.961,P<0.001)。并发症发生率为18.87%,主要为面部麻木及眼干。单因素分析显示病程的长短和既往手术治疗影响术后PTN的改善,而多因素分析仅病程影响GKS的预后。结论GKS治疗PTN疗效显著、定位精准、并发症少,是PTN患者的主要治疗方式,对于确诊的PTN患者应建议其早期首选GKS治疗,如果GKS治疗后效果欠佳可再次GKS治疗或结合其他治疗方式综合治疗。Objective To summarize and analyze the experience of Gamma Knife Surgery(GKS)in the treatment of primary trigeminal neuralgia(PTN).Methods Fifty-three patients with PTN,admitted by the Department of Neurosurgery of the Second Hospital of Shandong University from May 2016 to December 2019,were analyzed retrospectively to evaluate the efficacy,safety and the prognosis influential factors.Results The pain relief time after GKS is 35(7.5,85)d,and the pain relief rate after GKS is 90.57%.Compared with the preoperative BNI grading,The BNI grading after GKS was significantly improved,and the difference between them was statistically significant(Z=-5.961,P<0.001).The complication rate of GKS was 18.87%,which were mainly facial numbness and dry eyes.Univariate analysis showed that PTN duration and previous surgery affected the remission of PTN after GKS,while multivariate analysis showed the only factor that affected the prognosis of GKS was PTN duration.Conclusion GKS is the main treatment for patients with PTN due to its remarkable curative effect,precise positioning and few complications.For patients with confirmed PTN,GKS should be recommended in the early stage of the disease.If the outcome of GKS is not satisfactory,GKS can be repeated or combined with other treatments.

关 键 词：三叉神经痛 颅神经 伽玛刀 

分 类 号：R745.11[医药卫生—神经病学与精神病学]