局部麻醉下球囊压迫治疗三叉神经痛合并Ⅱ型呼吸衰竭1例  

Balloon compression under local anesthesia in the treatment of refractory trigeminal neuralgia complicated with type Ⅱ respiratory failure in 1 case

作　　者：杨宿梅 赵艺锦 张悦 欧册华 李富波 YANG Sumei;ZHAO Yijin;ZHANG Yue;OU Cehua;LI Fubo(Department of Anesthesiology,Hejiang County People's Hospital,Sichuan Province,Hejiang 646000,China;Department of Anesthesiology,Southwest Medical University,Sichuan Province,Luzhou 646000,China;Department of Pain,the Affiliated Hospital of Southwest Medical University,Sichuan Province,Luzhou 646000,China)

机构地区：[1]四川省合江县人民医院麻醉科,四川合江646000 [2]西南医科大学麻醉学系,四川泸州646000 [3]西南医科大学附属医院疼痛科,四川泸州646000

出　　处：《中国当代医药》2025年第4期144-147,共4页China Modern Medicine

基　　金：四川省医学青年创新科研课题计划项目(Q23099);四川省泸州市人民政府-西南医科大学科技战略合作项目(2023LZXNYDJ018);四川省合江县人民医院-西南医科大学科技战略合作项目(2023HJXNYD05);西南医科大学大学生创新创业训练计划项目(S202310632173、2024417);西南医科大学教学教改项目(JG2023yb093)。

摘　　要：三叉神经痛是一种常见的神经病理性疼痛,严重影响患者生活质量。而Ⅱ型呼吸衰竭则是由于各种原因引起的通气和换气功能严重障碍,导致低氧血症伴高碳酸血症。三叉神经痛合并Ⅱ型呼吸衰竭较为罕见,给临床治疗带来极大挑战。目前对于三叉神经痛的治疗方法主要有药物治疗、手术治疗及微创介入治疗等,对于Ⅱ型呼吸衰竭则以改善通气、纠正低氧和高碳酸血症为主。本病例以“发作性左侧颌面部疼痛3个月”主诉入院,诊断为三叉神经痛合并Ⅱ型呼吸衰竭,既往肺尘埃沉着病10余年病史的患者。患者因三叉神经痛剧烈,药物疗效差且伴副作用,严重影响日常生活,同时合并Ⅱ呼吸衰竭,治疗难度较大。通过综合评估患者病情,制定了局部麻醉下的三叉神经半月节球囊压迫术,手术成功,术后恢复好。该病例为临床处理类似复杂情况提供了一些处理经验,提醒临床医生在面对多病症合并时,需全面考虑病情,权衡各种治疗方法的利弊,以制定最适合患者的治疗方案,提高患者的生活质量和预后。Trigeminal neuralgia is a common neuropathic pain,which seriously affects the quality of life of patients.Type Ⅱ respiratory failure is due to a variety of causes of ventilation and ventilation function serious obstacles,leading to hypoxemia with hypercapnia.Trigeminal neuralgia combined with type Ⅱ respiratory failure is rare,which brings great challenges to clinical treatment.At present,the treatment of trigeminal neuralgia mainly includes drug therapy,surgical treatment and minimally invasive interventional therapy.For type Ⅱ respiratory failure,it is mainly to improve ventilation,correct hypoxia and hypercapnia.This case is admitted to the hospital with the chief complaint of"paroxysmal left maxillofacial pain for 3 months".The patient is diagnosed as trigeminal neuralgia with type Ⅱ respiratory failure and has a history of pneumoconiosis for more than 10 years.The patient has severe trigeminal neuralgia,poor drug efficacy and side effects,which seriously affects daily life.At the same time,it is difficult to treat with Ⅱ respiratory failure.Through a comprehensive assessment of the patient's condition,a balloon compression of the trigeminal ganglion under local anesthesia was developed.The operation was successful and the postoperative recovery was good.This case provides some experience for clinical treatment of similar complex situations.It reminds clinicians to fully consider the condition and weigh the advantages and disadvantages of various treatment methods in the face of multiple diseases,so as to formulate the most suitable treatment plan for patients and improve the quality of life and prognosis of patients.

关 键 词：三叉神经痛 球囊压迫 局部麻醉 神经痛 

分 类 号：R745.1[医药卫生—神经病学与精神病学]