摘要
目的验证数字血管减影术定位在射频治疗三叉神经痛卵圆孔穿刺的临床价值及其治疗效果。方法66例三叉神经痛患者在数字血管减影术定位下行三叉神经痛射频热凝术治疗,计算球管角度及穿刺深度。射频毁损设定为目标温度85℃,120 s,对其治疗效果进行近期与远期评价。结果正位球管向患侧倾斜角度(19．8±3．5)度,向尾侧倾斜角度(28．8±6．5)度,侧位向左(或右)倾斜(88±4．5)度,向头倾斜(5．5±2．5)度。穿刺深度,第Ⅲ支平均0．46 cm,第Ⅱ支平均1．36 cm。66例患者穿刺成功率100％,术后疼痛即刻消失率100％,随访5个月-3年,3例复发,并发角膜炎2例,头痛5例,并发症发生率0．11％。结论数字血管减影术定位下穿刺卵圆孔,施行三叉神经射频治疗是治疗三叉神经痛的一种安全、准确、客观、效佳的方法。
Objective To study the therapeutic effects and the clinical value of digital subtraction angiography（DSA） in radiofrequency thermocoagulation for treatment of trigeminal neuralgia. Methods Sixty six cases suffering from trigeminal neuralgia were treated with radiofrequency thermocoagulation guided by digital subtraction angiography. Radiofrequency coagulation was performed at 85℃ for 120 seconds. The sloping degrees of the roentgenologic tube and puncture depth were measured during the procedure. The therapeutic effects and side effects were assessed after treatment. Results In the posteroanterior view, the angle of roentgenologic tube at caudal was （28.8 ±6.5） degrees and lateral（ right or left） was（ 19.8 ±3.5） degrees. In the lateral view, the angle of roentgenologic tube at cephalic was （5.5 ± 2.5 ） degrees and lateral （ right or left） was （88 ± 4.5 ） degrees. Average depth of the second branch was 1.36 cm. the third branch was 0.46 cm. The post-operative successful rate was 100%. The immediate pain relief rate was 100%. The relapse rate was 0.05% after 5 month to three years fellow-up. Two cases had complications of keratitis （0.03%）. Five cases had complications of headache（0.08% ）. Conclusion It is a safe, precision, objective,convenient localization method to puncture oval foramen under the guidance of digital subtraction angiography for the treatment of trigeminal neuralgia with good short-and long-term outcomes.
出处
《实用疼痛学杂志》
2007年第2期88-92,共5页
Pain Clinic Journal
关键词
数字减影血管造影术
立体定位技术
三叉神经痛
导管消融术
射频热凝术
卵圆孔
Digital Subtraction Angiography
Stereotaxil Techniques
Trigeminal Neuralgia
Catheter Ablation, Radiofrequency
Thermocoagulation
Foramen Ovale
