微球囊压迫术与射频热凝术治疗三叉神经痛的疗效及复发临床分析  

Clinical analysis of the effect and recurrence of microballoon compression and radiofrequency thermocoagulation in the treatment of trigeminal neuralgia

作　　者：樊宝华[1] 吴祎炜 张文川 FAN Baohua;WU Yiwei;ZHANG Wenchuan(Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属上海第九人民医院,上海200011

出　　处：《中国实用神经疾病杂志》2024年第10期1212-1216,共5页Chinese Journal of Practical Nervous Diseases

基　　金：上海市中医药事业发展三年行动计划[编号:ZY(2018-2020)-ZWB-1001-CP36]。

摘　　要：目的分析经皮微球囊压迫术(PMC)与射频热凝术(RFT)治疗三叉神经痛(TN)患者的疗效及复发情况。方法选取2020-06—2023-05上海交通大学医学院附属上海第九人民医院收治的220例TN患者为研究对象,根据治疗方法分为PMC组(110例)和RFT组(110例),比较2组疗效、疼痛情况[数字疼痛评分(NRS)]、炎症指标[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)]、应激指标[去甲肾上腺素(NE)、皮质醇(Cor)]、术后并发症和复发情况。结果2组总有效率比较,差异无统计学意义(P>0.05)。术后1、3个月,PMC组NRS评分低于RFT组(t=6.717、4.184,P<0.05)。术后3 d,PMC组血清TNF-α、IL-1β、IL-6低于RFT组(t=5.876、5.932、6.289,P<0.05)。术后24 h,PMC组血清NE、Cor低于RFT组(t=4.962、7.224,P<0.05)。PMC组咬肌无力发生率高于RFT组(χ^(2)=7.952,P<0.05)。2组面部麻木、口面部疱疹、角膜炎发生率比较,差异均无统计学意义(P>0.05)。2组复发率比较,差异无统计学意义(P>0.05)。结论PMC和RFT均为TN的有效治疗方法,PMC在改善术后疼痛、降低炎症反应和应激反应方面效果更佳。Objective To analyze the effect and recurrence of percutaneous microballoon compression(PMC)and radiofrequency thermocoagulation(RFT)in the treatment of trigeminal neuralgia(TN).Methods A total of 220 patients with TN in Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine were enrolled as the research objects between June 2020 and May 2023.According to different treatment methods,they were divided into PMC group(110 cases)and RFT group(110 cases).The curative effect,pain level(numerical rating scale,NRS),inflammatory indexes(tumor necrosis factorα(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6)),stress indexes(norepinephrine(NE),cortisol(Cor)),postoperative complications and recurrence were compared between the two groups.Results There was no significant difference in total response rate between the two groups(P>0.05).At 1 month and 3 months after surgery,NRS scores in PMC group were lower than those in RFT group(t=6.717,4.184,P<0.05).At 3 days after surgery,the levels of serum TNF-α,IL-1βand IL-6 in PMC group were lower than those in RFT group(t=5.876,5.932,6.289,P<0.05).At 24 hours after surgery,the levels of serum NE and Cor in PMC group were lower than those in RFT group(t=4.962,7.224,P<0.05).The incidence of masseteric asthenia in PMC group was higher than that in RFT group(χ^(2)=7.952,P<0.05).There was no significant difference in the incidence of facial numbness,oral and facial herpes or keratitis between the two groups(P>0.05).There was no significant difference in recurrence rate between the two groups(P>0.05).Conclusion Both PMC and RFT are effective in the treatment of TN.However,PMC can better relieve postoperative pain,and reduce inflammatory response and lower than those in RFT group(t=4.962,7.224,P<0.05).The incidence of masseteric asthenia in PMC group was higher than that in RFT group(χ^(2)=7.952,P<0.05).There was no significant difference in the incidence of facial numbness,oral and facial herpes or keratitis between the two groups(P>0.05).There was no sig

关 键 词：三叉神经痛 微球囊压迫术 射频热凝术 术后疼痛 炎症反应 应激反应 复发 

分 类 号：R745.11[医药卫生—神经病学与精神病学]