微血管减压术治疗三叉神经痛及面肌痉挛长期随访  

Long-term follow-up results of microvascular decompression in trigeminal neuralgia and hemifacial spasm

作　　者：赵长地[1] 孔姣[1] 

机构地区：[1]新疆喀什地区第一人民医院神经外科,844000

出　　处：《立体定向和功能性神经外科杂志》2004年第1期30-32,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的　评价微血管减压术 (microvasculardecompression ,MVD)治疗三叉神经痛及面肌痉挛的长期随访结果。方法　 1984～ 1994年完成并随访 5年以上的MVD手术 16 5 2例 ,共分 2组。A组为早期手术组 (1984～1989年 ) ,797例 ,其中三叉神经痛 5 87例 ,面肌痉挛 2 10例 ,随访 10 .2～ 15 .8年 ,平均 13.2± 2 .4年。B组为近期手术组 (1990～ 1994年 ) ,85 5例 ,其中三叉神经痛 6 4 9例 ,面肌痉挛 2 0 6例 ,随访 5 .3～ 10 .1年 ,平均 7.6± 2 .1年。结果　病人对MVD手术满意率 :三叉神经痛A组为 86 .7% ,B组为 91.5 % ;面肌痉挛A组为 81.9% ,B组为88.3%。治愈率 :三叉神经痛A组为 97.1% ,B组为 98.5 % ;面肌痉挛A组为 78.1% ,B组为 85 .9%。复发率 :三叉神经痛A组为 3.4 % ,B组为 2 .2 % ;面肌痉挛A组为 11.9% ,B组为 8.7%。并发症发生率 :三叉神经痛A组为9% ,B组为 2 % ;面肌痉挛A组为 14 .7% ,B组为 8.2 %。结论　提高手术熟练程度 ,改善操作技巧 ,彻底分离神经血管周围的蛛网膜 ,充分地减压是获得长期满意手术效果的重要因素。Objective To evaluate the long-term follow-up results of microvascular decompression (MVD) for treatment of trigeminal neuralgia(TN) and hemifacial spasm(HFS).Methods 1652 cases underwent MVD between 1984～1994 and were followed for more than 5 years.They were divided into two groups and their follow-up results were compared and studied.The early series,Group A(1984～1989) comprised 797 patients (587 with TN and 210 with HFS) followed from 10.2～15.8 years(mean,13.2±2.4 years),and the recent series,Group B(1990~1994) comprised 855 patients (649 with TN and 206 with HFS) followed from 5.3～10.1 years(mean,7.6±2.1 years).Results The satisfactory rates of the patients to MVD obtained by the follow-up study were 86.7% in group A and 91.5% in group B for TN and 81.9% in group A and 88.3% in group B for HFS.The postoperative cure rates were 97.1% in group A and 98.5% in group B for TN and 78.1% in group A and 85.9% in group B for HFS.Recurrence rates were 3.4% in group A and 2.2% in group B for TN and 11.9% in group A and 8.7% in group B for HFS.Postoperative complications rates were 9% in group A and 2% in group B for TN and 14.7% in group A and 8.2% in group B for HFS.Conclusions Advancing the experienced level of operation,improving the operative technique,sufficient rsection of the the thick arachnoid membrance around the nerve and vascular,and decompression fully and properly are important to obtain satisfactory long-term follow-up results.

关 键 词：微血管减压术 手术治疗 三叉神经痛 面肌痉挛 长期随访 手术方法 

分 类 号：R745.11[医药卫生—神经病学与精神病学] R745.12[医药卫生—临床医学]