三叉神经痛显微血管减压术中岩静脉的分型及处理策略  

Classification and protective strategies of superior petrosal vein in micorvascular decompression for trigeminal neuralgia

作　　者：姜成荣 徐武[1] 种玉龙 王晶[1] 周璐 梁维邦[1] Jiang Chengrong;Xu Wu;Chong Yulong;Wang Jing;Zhou Lu;Liang Weibang(Department of Neurosurgery,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院神经外科,南京210008

出　　处：《中华脑科疾病与康复杂志（电子版）》2021年第4期200-203,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探讨原发性三叉神经痛(TN)行显微血管减压术(MVD)中岩静脉的处理策略。方法回顾性分析自2017年8月至2019年2月在南京大学医学院附属鼓楼医院神经外科接受MVD的221例原发性TN患者的临床资料。根据岩静脉与三叉神经及听神经的位置关系将岩静脉分为3型,总结不同类型岩静脉的保护策略。结果本组患者中岩静脉Ⅰ型67例(30.3%),Ⅱ型125例(56.6%),Ⅲ型29例(13.1%)。选择合适的处理策略,所有患者岩静脉主干均完整保留,术后213例患者面部疼痛完全消失,7例患者面部疼痛明显缓解,1例患者无明显改善。术后无死亡、脑出血、脑梗死等严重并发症发生。结论通过岩静脉分型并选择合适的手术策略,可以有效地保护岩静脉,对提高MVD治疗TN的安全性及减少术后并发症方面具有重要的意义。Objective To explore the surgical strategy of treating superior petrosal vein in microvascular decompression(MVD)for primiary trigeminal neuralgia(TN).Methods The clinical data of 221 patients with primary TN who underwent MVD in the Neurosurgery Department of Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School from August 2017 to February 2019 were analyzed retrospectively.Based on the location realtionship between superior petrosal vein and trigemianl nerve and auditory nerve,the superior petrosal vein was diviede into three types.The protective strategies of different types of superior petrosal vein were summed up.Results There were 67 cases(30.3%)of typeⅠ,125 cases(56.6%)of typeⅡ,and 29 cases(13.1%)of typeⅢ.After MVD,the facial pain disappeared in 213 patients and relieved in 7 patients,1 patient showed no improvement after surgery.No superior petrosal vein was sacrificed and no serious complications like death,cerebral hemorrhage or cerebral infarction were observed.Conclusion Classification of superior petrosal vein and selection of appropriate surgical strategy can effectively protect superior petrosal vein,which is of great significance to improve the safety of MVD in the treatment of TN and reduce postoperative complications.

关 键 词：三叉神经痛 显微血管减压术 岩静脉 

分 类 号：R651.3[医药卫生—外科学]