比较经皮射频热凝术与球囊压迫术治疗原发性三叉神经痛患者疗效和安全性的Meta分析  

Comparison of efficacy and safety between percutaneous radiofrequency thermocoagulation and percutaneous balloon compression for the treatment of trigeminal neuralgia: a meta-analysis

作　　者：武晓可 连亚军[1] 陈媛[1] 史萌萌 张海峰[1] Wu Xiaoke;Lian Yajun;Chen Yuan;Shi Mengmeng;Zhang Haifeng(Department of Neurology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou City,Henan Province 450052,China;Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou City,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院神经内科,郑州市450052 [2]郑州大学第一附属医院眼科,郑州市450052

出　　处：《中华疼痛学杂志》2023年第1期36-43,共8页Chinese Journal Of Painology

摘　　要：目的分析经皮射频热凝术(PRT)与经皮球囊压迫术(PBC)治疗三叉神经痛(TN)的疗效和安全性。方法计算机检索中国知网、万方、维普、Cochrand Library、PubMed、Embase数据库, 时间从建库至2022年6月30日, 收集有关PRT和PBC治疗TN的随机对照研究(RCTs)。按照纳入与排除标准筛选文献, 使用RevMan 5.4软件进行Meta分析, 采用Cochrane系统评价工具对纳入文献进行质量评价。结果共纳入10篇文献, 包含2 033例TN患者。Meta分析结果显示:术后24个月, PBC组较PRT组疼痛数字评分(NRS)更低, 差异有统计学意义(MD=1.22, 95%CI:0.17~2.27, P=0.02);术后7 d、6个月及12个月两组NRS评分差异无统计学意义(P均>0.05)。术后PRT组较PBC组疼痛缓解率高, 差异有统计学意义(OR=0.76, 95%CI:0.60~0.96, P=0.02)。术后PRT组咀嚼肌无力发生情况较PBC组低, 差异有统计学意义(OR=0.38, 95%CI:0.19~0.76, P=0.0 006);此外术后两组在面部麻木、角膜反射减弱、带状疱疹发生率及术后复发方面差异无统计学意义(P均>0.05)。结论 PRT较PBC术后疼痛缓解率更高, 不良反应发生率更低, 但PBC远期疼痛程度更低。Objective To analyze the efficacy and safety of percutaneous radiofrequency thermocoagulation(PRT)and percutaneous balloon compression(PBC)in the treatment of trigeminal neuralgia(TN).Methods Literatures of randomized controlled trials(RCTs)on PRT and PBC for TN were searched in the databases of CNKI,Wanfang,Weipu,Cochrand Library,PubMed and Embase from the establishment of the database to June 30,2022.According to the inclusion and exclusion criteria,the selected literatures were performed meta-analysis using RevMan 5.4 software.Results A total of 10 literatures included 2033 TN patients were enrolled.The meta-analysis showed that PBC group had significantly lower numeric rating scales(NRS)than that in PRT group at 24 months(MD=1.22,95%CI:0.17-2.27,P=0.02),but no significant difference at 7 days,6 months and 12 months between PBC group and PRT group after the treatment(all P>0.05).Pain relief rate was significantly higher in PRT group than that in PBC group after the operation(OR=0.76,95%CI:0.60-0.96,P=0.02).The incidence of masticatory muscle weakness was lower in PRT group than that in PBC group after the operation(OR=0.38,95%CI:0.19-0.76,P=0.0006).There were no significant difference in facial numbness,corneal reflex decreased,herpes zoster incidence,and postoperative recurrence between the two groups(all P>0.05).Conclusion PRT has a higher rate of postoperative pain relief and a lower incidence of adverse reactions,but lower long-term NRS efficacy than PBC.

关 键 词：三叉神经痛 经皮射频热凝术 经皮球囊压迫术 META分析 

分 类 号：R651.3[医药卫生—外科学]