DSA类CT成像技术引导弯针经不同途径射频热凝治疗三叉神经痛的效果对比  

Comparison on the curative effect of radiofrequency thermocoagulation with Dyna CT guided curved needle through different approaches on trigeminal neuralgia

作　　者：李达 郑姝文 朱文阳 孙娜 左小华 LI Da;ZHENG Shuwen;ZHU Wenyang;SUN Na;ZUO Xiaohua(Huai’an Second People’s Hospital/Huai’an Hospital Affiliated to Xuzhou Medical University,Huai’an 223001,China)

机构地区：[1]淮安市第二人民医院(徐州医科大学附属淮安医院),江苏淮安223001

出　　处：《中国实用神经疾病杂志》2024年第2期200-205,共6页Chinese Journal of Practical Nervous Diseases

基　　金：江苏省中医药科技发展计划项目(编号:MS2022107)。

摘　　要：目的探讨DSA类CT成像技术(Dyna CT)引导弯针经不同途径射频热凝(RFTC)治疗三叉神经痛(TN)第2支的效果。方法选取2013-01—2021-12徐州医科大学附属淮安医院疼痛科收治的90例第2支TN患者,采用随机数字表法分为A组和B组,每组45例。A组采用Dyna CT引导弯针经圆孔外口路径RFTC治疗,B组患者采用Dyna CT引导弯针经圆孔内口路径RFTC治疗。比较2组平均操作时间、一次性穿刺成功率和不同时间点累计缓解率、视觉模拟评分法(VAS)评分、匹兹堡睡眠质量指数(PSQI)评分及术后并发症、复发率。结果A组操作时间(20.47±2.65)min,显著低于B组的(24.39±3.14)min;一次性穿刺成功率88.89%,显著高于B组的71.11%(P<0.05)。术后1周、8周和12周,A组累计缓解率分别为62.22%、71.11%和77.78%,显著高于B组的40.00%、48.89%和57.78%(P<0.05)。术后1周、8周和12周,A组VAS评分分别为(5.69±0.95)分、(4.64±0.65)分和(3.13±0.48)分,高于B组的(5.01±1.03)分、(3.98±0.78)分和(2.45±0.86)分;PSQI评分分别为(15.02±2.34)分、(12.51±1.09)分和(9.87±0.75)分,高于B组的(12.45±2.58)分、(10.05±1.18)分和(7.33±0.89)分(P<0.05)。A组TN患者术后12个月复发率24.83%,高于B组的6.67%(P<0.05)。结论与经圆孔外口穿刺入路比较,Dyna CT引导弯针经圆孔内口穿刺RFTC可有效提高TN疗效,减轻术后疼痛反应,降低远期复发率。Objective To investigate the curative effect of radiofrequency thermocoagulation(RFTC)with Dyna CT guided curved needle through different approaches on V2 trigeminal neuralgia(TN).Methods A total of 90 patients with V2 TN admitted to Department of Pain Management in the Huai’an Second People’s Hospital were enrolled between January 2013 and December 2021.According to random number table method,they were divided into group A and group B,45 cases in each group.The group A was given RFTC with Dyna CT guided curved needle through external foramen rotundum approach,while group B was given RFTC with Dyna CT guided curved needle through internal foramen rotundum approach.The average operation time,success rate of one-time puncture,cumulative remission rate at different time points,scores of visual analogue scale(VAS)and Pittsburgh sleep quality index(PSQI),postoperative complications and recurrence rate were compared between the two groups.Results The average operation time in group A was significantly shorter than that in group B((20.47±2.65)min vs(24.39±3.14)min),and success rate of one-time puncture was significantly higher than that in group B(88.89%vs 71.11%,P<0.05).At 1 week,8 weeks and 12 weeks after surgery,cumulative remission rates in group A were 62.22%,71.11%and 77.78%,respectively,significantly higher than those in group B(40.00%,48.89%,57.78%,respectively,P<0.05).At 1 week,8 weeks and 12 weeks after surgery,VAS scores in group A were(5.69±0.95)points,(4.64±0.65)points and(3.13±0.48)points,respectively,which were higher than those in group B((5.01±1.03)points,(3.98±0.78)points,(2.45±0.86)points,respectively),and PSQI scores were(15.02±2.34)points,(12.51±1.09)points and(9.87±0.75)points,respectively,which were higher than those in group B((12.45±2.58)points,(10.05±1.18)points,(7.33±0.89)points,respectively,P<0.05).At 12 months after surgery,the recurrence rate in group A was higher than that in group B(24.83%vs 6.67%,P<0.05).Conclusion Compared with external foramen rotundum,RFTC with Dyna

关 键 词：Dyna CT引导 弯针 圆孔内口 圆孔外口 射频热凝 三叉神经痛 

分 类 号：R745.11[医药卫生—神经病学与精神病学]