三叉神经痛微血管减压术后疗效分析及复发后再次手术策略  

Efficacy of microvascular decompression in treatment of trigeminal neuralgia and reoperation strategies after recurrence

作　　者：张帅[1] 杨治权[2] 樊天禹 尹江柳 龚勇 符星 王红鑫 ZHANG Shuai;YANG Zhi-Quan;FAN Tian-Yu;YIN Jiang-Liu;GONG Yong;FU Xing;WANG Hong-Xin(Department of Neurosurgery,Changsha Central Hospital Affiliated to Nanhua University,Changsha,Hunan 410018,China;Department of Neurosurgery,Xiangya Hospital of Central South University,Changsha,Hunan 410008,China)

机构地区：[1]南华大学附属长沙中心医院神经外科,湖南长沙410018 [2]中南大学湘雅医院神经外科,湖南长沙410008

出　　处：《国际神经病学神经外科学杂志》2021年第5期425-428,共4页Journal of International Neurology and Neurosurgery

基　　金：湖南省自然科学基金面上项目(2020JJ4637)。

摘　　要：目的探讨三叉神经痛微血管减压(MVD)术的疗效及复发因素与再次手术策略。方法选择2017年10月—2020年8月南华大学附属长沙中心医院神经外科收治的256例三叉神经痛患者,采用MVD治疗,随访6个月,分析临床疗效、复发因素、再次手术策略。结果256例患者,223例(87.1%)完全治愈;15例(5.9%)好转;6例(2.3%)未愈;12例(4.7%)复发;总有效率为93.0%(238/256),无效发生率7.0%(18/256)。18例无效患者二次手术后随访6个月,17例缓解,1例行三叉神经半月节球囊压迫术无效。统计分析显示,年龄、神经血管压迹、血管压迫分型是三叉神经痛MVD术后复发的危险因素(P<0.05)。结论MVD治疗三叉神经痛的临床疗效确切,应注意分析术后复发因素及再次手术策略。Objective To investigate the efficacy of microvascular decompression(MVD)in the treatment of trigeminal neuralgia and related recurrence factors and reoperation strategies.Methods A total of 256 patients with trigeminal neuralgia who received MVD in Department of Neurosurgery,Changsha Central Hospital Affiliated to Nanhua University,from October 2017 to August 2020 were enrolled,and the patients were followed up for 6 months to analyze clinical outcome,recurrence factors,and reoperation strategies.Results Among the 256 patients,223(87.1%)were completely cured,15(5.9%)were improved,6(2.3%)were not cured,and 12(4.7%)experienced recurrence.The overall response rate was 93.0%(238/256),and the non-response rate was 7.0%(18/256).The 18 patients with no response were followed up for 6 months after the second operation,among whom 17 achieved remission and 1 had no response to balloon compression of the trigeminal semilunar ganglion.The statistic analysis showed that age,neurovascular impression,and type of vascular compression were the risk factors for recurrence of trigeminal neuralgia after MVD(P<0.05).Conclusions MVD has a marked clinical effect in the treatment of trigeminal neuralgia,and postoperative recurrence factors and reoperation strategies should be analyzed and taken seriously.

关 键 词：三叉神经痛 微血管减压 复发 再次手术 

分 类 号：R745.11[医药卫生—神经病学与精神病学]