微球囊压迫术与微血管减压术治疗三叉神经痛的疗效及不良反应评估  

Evaluation of Efficacy and Side Effects of Percutaneous Balloon Compression and Microvascu⁃lar Decompression in Treatment of Trigeminal Neuralgia

作　　者：刘振波 王明宇 连世忠[2] LIU Zhen-bo;WANG Ming-yu;LIAN Shi-zhong(First Clinical College of Shanxi Medical University,Taiyuan 031000,China;Department of Neurosurgery,First Hospital of Shanxi Medical university,Taiyuan 031000,China)

机构地区：[1]山西医科大学第一临床医学院,太原031000 [2]山西医科大学第一医院神经外科,太原031000

出　　处：《神经损伤与功能重建》2023年第4期197-200,共4页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨神经导航及C臂辅助下经皮三叉神经微球囊压迫术(PBC)与显微镜下微血管减压术(MVD)治疗三叉神经痛的疗效及安全性。方法:回顾性搜集我院收治的三叉神经痛患者144例的临床资料,根据治疗方法分为MVD组67例和PBC组77例,分析、比较2组患者的术前因素、术后疗效及并发症、住院时间、手术时长等数据。结果:PBC组患者年龄大于MVD组(P<0.05)。2组患者在术后即刻、术后6个月及术后1年时的疼痛缓解率差异无统计学意义(均P>0.05);对于年龄>60岁的患者,PBC治疗后的疼痛缓解率显著高于MVD(P<0.05)。2组手术并发症存在差异,MVD组眩晕发生率为60.0%,明显高于PBC组(P<0.05);PBC组面部麻木(52.6%)、咀嚼肌无力(40.2%)和疱疹(7.79%)的发生率明显高于MVD组(P<0.05)。PBC组的手术时长和住院天数均显著低于MVD组(P<0.05)。结论:PBC和MVD治疗三叉神经痛的总体疗效相似,并发症存在差异,老年患者更适合选择PBC治疗。Objective:To explore the safety and efficacy of neuronavigation and C-arm-assisted percutaneous balloon compression(PBC)and microvascular decompression(MVD)in treating trigeminal neuralgia.Methods:Clinical data of 144 patients treated for trigeminal neuralgia at our hospital were retrospectively collected.Patients were divided into the MVD group(n=76)and PBC group(n=77)based on method of treatment.Preop-erative factors,postoperative efficacy and complications,length of hospitalization,and duration of operation were analyzed and compared between the two groups.Results:The patients in PBC group were older than the patients MVD group(P<0.05).There was no statistical difference in the pain relief rate of the two groups immediately,6 months,and 1 year after surgery(all P>0.05).In patients aged>60,the postoperative pain relief rate af-ter PBC was higher than that after MVD(P<0.05).The two groups showed differences in postoperative complication.The incidence of vertigo was 60.0%in the MVD group,significantly higher than that in the PBC group(P<0.05).In the PBC group,the incidence of facial numbness(52.6%),masticatory muscle disorder(40.2%),and herpes(7.79%)were significantly higher than those in the MVD group(all P<0.05).Operation time and hospitalization time were both significantly lower in the PBC group compared to the MVD group(all P<0.05).Conclusion:PBC and MVD show similar efficacy in the treatment of trigeminal neuralgia but show differences in postoperative complications.In the elderly,PBC is the more suitable procedure.

关 键 词：原发性三叉神经痛 球囊压迫术 微血管减压术 并发症 疼痛缓解率 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学] R745