球囊压迫术与微血管减压术治疗原发性三叉神经痛的疗效分析  

Effectivenes of surgical treatment for primary trigeminal neuralgia:percutaneous balloon compression versus microvascular decompression

作　　者：彭若愚[1] 林劲芝[1] 罗国轩[1] 刘佳文 张勇[1] PENG Ruo-yu;LIN Jin-zhi;LUO Guo-xuan;LIU Jia-wen;Zhang Yong(Department of Neurosurgery,Guangdong Second Provincial General Hospital,Guangzhou 510000,China)

机构地区：[1]广东省第二人民医院神经外科,广州510000

出　　处：《中国临床神经外科杂志》2022年第10期835-836,868,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨球囊压迫术(PBC)与微血管减压术(MVD)治疗原发性三叉神经痛(PTN)的疗效。方法回顾性分析2016年2月至2021年7月手术治疗的156例PTN的临床资料。应用PBC治疗79例(PBC组),MVD治疗77例(MVD组)。结果术后1年,PBC组有效率(93.7%)与MVD组(90.9%)无统计学差异(P>0.05)。PBC组术后面部麻木发生率(93.7%)、口唇疱疹发生率(39.2%)明显高于MVD组(分别为46.8%、3.9%;P<0.05),而耳鸣发生率(0%)明显低于MVD组(11.7%;P<0.05)。PBC组术后1年复发率(10.8%,8/74)与MVD组(5.7%,4/70)无统计学差异(P>0.05)。结论PBC与MVD治疗PTN疗效肯定,各具优势。术前影像学检查有明确责任血管的PTN,优先选择MVD治疗;顽固复发、年老体弱以及存在基础病的PTN,建议选择PBC治疗。Objective To compare the effectivenes of percutaneous balloon compression(PBC)and microvascular decompression(MVD)for the patients with primary trigeminal neuralgia(PTN).Methods The clinical data of 156 patients with PTN,of whom 79 patients received PBC(PBC group)and 77 received MVD(MVD group),from February 2016 to July 2021 were analyzed retrospectively.Results There was no significant difference in the effective rate between PBC group(93.7%)and MVD group(90.9%)1 year after the operation(P>0.05).The rates of facial numbness(93.7%)and oral herpes(39.2%)in the PBC group were significantly higher than those in the MVD group(46.8%and 3.9%,respectively;P<0.05),and the incidence of tinnitus(0%)in the PBC group was significantly lower than that(11.7%)in the MVD group(P<0.05).There was no significant difference in the recurrence rate between PBC group(10.8%,8/74)and MVD group(5.7%,4/70)1 year after operation(P>0.05).Conclusions Both PBC and MVD are effective in the treatment of the patients with PTN.MVD is preferred for the PTN patients with definite responsible vessels on preoperative images.PBC is recommended for the PTN patients with repeated recurrence,old age,infirmity,or chronic diseases.

关 键 词：原发性三叉神经痛 经皮球囊压迫术 微血管减压术 疗效 

分 类 号：R745.11[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]