3D打印导板辅助射频温控热凝术治疗第三支三叉神经痛的临床研究  

Clinical study of 3D printing navigation template-guided percutaneous radiofrequency thermocoagulation for V3 trigeminal neuralgia treatment

作　　者：郑政 陈冬雷[1] 陈勇军[1] 王翔[1] ZHENG Zheng;CHEN Donglei;CHEN Yongjun;WANG Xiang(Department of Stomatology,the First People's Hospital of Nantong,Jiangsu Province,the Second Affiliated Hospital of Nantong University,Nantong 226001)

机构地区：[1]江苏省南通市第一人民医院,南通大学第二附属医院口腔科,南通226001

出　　处：《南通大学学报（医学版）》2022年第1期32-35,共4页Journal of Nantong University(Medical sciences)

基　　金：南通市科技计划项目(JCZ19008,MS12020032)。

摘　　要：目的:评价3D打印导板辅助射频温控热凝术治疗第三支三叉神经痛的临床效果。方法:收集从2017年9月—2021年6月在南通市第一人民医院口腔科接受治疗的60例原发性第三支三叉神经痛患者,根据是否选用3D打印导板,将患者分为常规组(n=30)和导板组(n=30)。记录患者年龄、性别、侧别、病程、术前、术后即刻及术后6个月疼痛数字评分法(numerical rating scale,NRS)评分、穿刺成功率、穿刺时间、手术时间、X线曝光次数及术后并发症等情况。结果:两组患者年龄、性别、侧别、病程、疼痛程度等方面差异均无统计学意义(均P>0.05);常规组一次性穿刺成功率为20.0%,导板组为93.3%,两组差异有统计学意义(P<0.05);常规组平均穿刺时间为(14.6±0.7)min,明显长于导板组的(1.3±0.4)min(P<0.05)。常规组手术时间为(39.7±0.5)min,导板组为(22.4±0.2)min,导板组明显短于常规组(P<0.05)。常规组术中X线曝光次数为(3.1±1.0)次,导板组为(1.0±0.2)次,导板组的X线曝光次数明显减少(P<0.05)。常规组术后即刻NRS评分为(2.9±0.6)分,导板组为(2.8±0.9)分,较术前NRS评分均明显下降,但差异无统计学意义(P>0.05)。术后6个月常规组NRS评分为(2.3±0.4)分,导板组为(2.1±0.8)分。根据NRS减轻的百分数,常规组临床总有效率为88.9%,导板组为89.3%,两组间差异无统计学意义(P>0.05)。两组患者术后均未出现咀嚼无力、角膜反射减弱、脑脊液漏等并发症,导板组出现面部血肿1例,常规组7例,两组差异有统计学意义(P<0.05)。结论:3D打印导板辅助射频温控热凝术治疗第三支三叉神经不仅能有效提高穿刺成功率,减少X线辐射,避免严重并发症,减轻患者疼痛,还可简化穿刺过程,在保证治疗效果的同时明显地提高了治疗效率,具有临床推广应用的价值。Objective:To evaluate the clinical efficacy of the 3D printing navigation template-guided percutaneous radiofrequency thermocoagulation for V3 trigeminal neuralgia treatment.Methods:60 patients with primary third trigeminal neuralgia in the First People′s Hospital of Nantong from September 2017 to June 2021 were collected and divided into routine treatment group(n=30)and guide plate group(n=30)according to whether to choose 3D printing navigation template.Age,gender,side,course of disease,numerical rating scale(NRS)score before surgery,immediately after surgery and 6 months after surgery,puncture success rate,puncture time,operation time,number of X-ray exposures and postoperative complications were recorded.Results:There were no statistical differences in age,gender,side,course of disease and pain degree between the two groups(P>0.05).The one-time puncture success rate was 20.0%in the routine treatment group and 93.3%in the guide plate group,and the difference between the two groups was statistically significant(P<0.05).The puncture time of routine treatment group was(14.6±0.7)min,significantly longer than that in the guide plate group(1.3±0.4)min,and the difference was statistically significant(P<0.05).The operation time was(39.7±0.5)min in the routine treatment group and(22.4±0.2)min in the guide plate group,and the operation time was significantly shortened in the guide plate group(P<0.05).The average number of X-ray exposures was(3.1±1.0)in the routine treatment group and(1.0±0.2)in the guide plate group,and the number of X-ray exposures was significantly decreased in the guide plate group(P<0.05).Immediate postoperative NRS score were(2.9±0.6)in the routine treatment group and(2.8±0.9)in the guide plate group,significantly lower than those before surgery,but there was no statistical significance between the two groups(P>0.05).6 months postoperative NRS score were(2.3±0.4)in the routine treatment group and(2.1±0.8)in the guide plate group.According to the percentage reduction of NRS,the total cli

关 键 词：第三支三叉神经痛 3D打印导板 射频温控热凝术 

分 类 号：R745.11[医药卫生—神经病学与精神病学]