摘要
目的介绍乙状窦后锁孔入路微血管减压术(MVD)治疗三叉神经痛(TN)的手术经验,探讨影响手术疗效的因素。方法回顾分析2697例TN患者的临床资料,重点介绍手术操作及注意事项。结果治愈2541例,显效76例,有效48例,无效31例,死亡1例。2190例接受3～240个月的随访,1965例治愈,91例显效,40例有效,30例无效,64例疼痛复发(其中37例行2次手术治愈)。结论异常血管压迫三叉神经入根区并合并局部蛛网膜增厚粘连是TN的主要病因。行MVD同时松解蛛网膜,做到彻底减压。依据病人的不同情况采取相应的减压措施是提高MVD治疗TN效果的重要手段。
Objectives To introduce the experience in treating trigeminal neuralgia by microvascular decompression through retrosigmoid approach, and to explore several problems of affecting its curative effects on trigeminal neuralgia. Methods The clinical data of 2 697 patients with trigeminal neuralgia undergoing microvaseular decompression were analyzed retrospectively. The points for attention to the operation were introduced importantly. Results Of 2 697 patients, 2 541 were cured, 76 significantly improved in the clinical symptoms, 48 improved in the clinical symptoms, 31 unchanged and 1 died. Of 2 190 patients were followed-up from 3 to 240 months, 1965 were cured, 91 significantly improved in the clinical symptoms, 40 improved in the clinical symptoms and 30 unchanged, and 64 suffered from recurrent neuralgia （among them, 37 were cured by the second operation）. Conclusions The abnormal vascular compression of root entry zone of trigeminal nerve and arachnoid membrane circling the nerve thickening and sticking to the nerve were the main cause of trigeminal neuralgia. The mirovascular decompression combined with releasing the adherent arachnoid membrance is an effective method to treat trigeminal neuralgia. According to different conditions, the different relevant measures.of decompression showed be taken for enhancing the curative effects.
出处
《中国临床神经外科杂志》
2007年第7期411-413,共3页
Chinese Journal of Clinical Neurosurgery
关键词
三叉神经痛
微血管减压术
疗效
Trigeminal neuralgia
Microvaseular decompression
Curative effect
