3D打印导板定位微球囊压迫术治疗原发性三叉神经痛的临床随机对照研究  

A randomized controlled clinical trial of microballoon compression with 3D printed guide plate for primary trigeminal neuralgia

作　　者：刘海建[1] 陈锴 崔志超 王芳[3] 王晶[4] 赵春燕[1] LIU Haijian;CHEN Kai;CUI Zhichao;WANG Fang;WANG Jing;ZHAO Chunyan(Department of Neurosurgery,Langfang Municipal People s Hospital,Langfang 065000,China)

机构地区：[1]廊坊市人民医院神经外科,廊坊065000 [2]廊坊市人民医院肿瘤科,廊坊065000 [3]廊坊市人民医院肾内科,廊坊065000 [4]廊坊市人民医院放射科,廊坊065000

出　　处：《临床神经外科杂志》2024年第4期429-433,共5页Journal of Clinical Neurosurgery

基　　金：廊坊市科技支撑计划项目(2019013093)。

摘　　要：目的 分析3D打印导板定位微球囊压迫术(PMC)与常规PMC治疗原发性三叉神经痛(PTN)的临床疗效及安全性。方法 选择廊坊市人民医院神经外科2020年1月—2022年12月收治的80例PTN患者作为研究对象,使用随机数字表法分成观察组与对照组各40例。对照组行常规PMC治疗,观察组行3D打印导板定位PMC治疗。比较两组手术一般情况、术后即刻疗效、手术前后不同时点疼痛视觉模拟量表(VAS)评分、术后12个月复发情况及术后并发症情况。结果 观察组首次穿刺成功率97.50%显著高于对照组27.50%(P<0.05)。观察组穿刺成功时间、手术总时间、住院时间、住院费用均显著优于对照组(P<0.05)。观察组术后即刻总有效率97.50%与对照组95.00%比较,差异无统计学意义(P>0.05)。两组术前及术后1、2周的VAS评分组间比较(P>0.05)显示,观察组术后4周时疼痛VAS评分显著低于同期对照组(P<0.05)。术后12个月,观察组合计复发率5.00%显著低于对照组合计复发率20.00%(P<0.05)。观察组术后面部麻木、咬肌无力、口唇疱疹发生率与对照组比较,差异无统计学意义(P>0.05)。结论 3D打印导板定位PMC较常规PMC能显著提高首次穿刺成功率,缩短穿刺时间与手术总时间,且术后即刻疗效及远期疗效均显著。Objective To analyze the clinical efficacy and safety of 3D printing guided percutaneous microballoon compression(PMC) and conventional PMC in the treatment of primary trigeminal neuralgia(PTN).Methods A total of 80 patients with PTN treated in the Department of Neurosurgeiy,Langfang Municipal People's Hospital from January 2020 to December 2022 were selected as the study objects.All patients were divided into observation group and control group with 40 cases in each group using random number table method.The control group received conventional PMC treatment,and the observation group received 3D printing guide positioning PMC treatment.The general situation of operation,immediate postoperative efficacy,pain visual analogue scale(VAS)score at different time points before and after operation,recurrence 12 months after operation and postoperative complications were compared between two groups.Results The success rate of first puncture in observation group was 97.50%,which was significantly higher than that in control group(27.50%,P<0.05).The puncture success time,total operation time,hospitalization time and hospitalization cost in observation group were significantly better than those in control group(P<0.05).The total effective rate was 97.50% in the observation group and 95.00% in the control group,the difference was not statistically significant(P>0.05).Comparison of VAS scores between two groups before surgery,1 and 2 weeks after surgery(P>0.05) showed that the VAS score of the observation group at4 weeks after surgery was significantly lower than that of the control group(P<0.05).At 12 months after operation,the recurrence rate of observation group was 5.00%,which was significantly lower than that of control group(20.00%)(P<0.05).The incidence of facial numbness,masseterie muscle weakness and herpes labialis in ohservation group was compared with that in control group,the difference was not statistically significant(P>0.05).Conclusions PMC with 3D printed guide plate can significantly improve the success rate

关 键 词：3D打印 导板定位 经皮穿刺微球囊压迫术 原发性三叉神经痛 治疗结果 

分 类 号：R651[医药卫生—外科学]