微血管减压术治疗三叉神经痛  

Microvascular decompression for primary trigeminal neuralgia

作　　者：洪波[1] 周晓平[1] 刘建民[1] 王文仲[1] 王莉[2] 龚建国[2] 金爱国[2] 曾浩[2] 陆建平[2] 

机构地区：[1]第二军医大学长海医院神经外科,上海200433 [2]第二军医大学长海医院放射科,上海200433

出　　处：《中国微创外科杂志》2003年第5期429-430,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨微血管减压术治疗原发性三叉神经痛的安全有效性。　方法　回顾分析微血管减压术治疗 13例原发性单侧三叉神经痛的临床资料。术前采用SE序列及三维稳态旋进快速成像 ( 3 -Dfastinflowwithsteady -stateprecession)序列进行MR扫描 ,手术采用乙状窦后入路 ,分离血管神经后用人造血管补片隔离。　结果　术中见所有三叉神经均受到血管压迫 ,11例为小脑上动脉压迫 ,1例为基底动脉和小脑上动脉压迫 ,1例为静脉压迫。术后疼痛完全消失 ,无手术死亡及永久性并发症。随访 11例 ,时间 6月～ 2 4月 ,平均 13月 ,无疼痛复发。ObjectiveTo evaluate the safety and efficacy o f microvascular deco mpression in the management of primary trigeminal neuralgia.Methods We review ed 13 patients with unilateral primary trigeminal neuralgia treated by microvasc ular decompression. Conventional spin-echo (SE) sequence and 3-D fast inflow wit h steady-state precession (3-D-FISP) sequence MRI scans were used preoperatively to find evidence of neurovascular compression. The operation was accessed by re trosigmoidal approach and the nerve root was separated away from pressure vessel s by artificial vascular patch.ResultsDuring operations it w as found that tr igeminal nerves were pressed on by blood vessels in all the cases (by the superi or cerebellar artery in 11 cases; by the basilar artery and the superior cerebel lar artery in 1 case; and by the vein in 1 case). Complete pain relief was achie ved in all the patients without mortality or permanent complications. Eleven pat ients were clinically followed for 6～24 months with a mean of 13 months, and no recurrence was seen. ConclusionsMicrovascular decompression is a safe and effective procedure in the treatment of primary trigeminal neuralgia.

关 键 词：三叉神经痛 微血管减压术 磁共振 

分 类 号：R745.11[医药卫生—神经病学与精神病学]