摘要
目的比较经皮半月节射频热凝术和颅后窝探查手术治疗原发性三叉神经痛的疗效。方法回顾性分析126例三叉神经痛病人的治疗情况,其中经皮半月节射频热凝术(射频治疗组)治疗60例,颅后窝探查手术(颅后窝手术组)治疗66例。结果射频治疗组术后有效率91.7%,颅后窝手术组为86.4%。颅后窝手术组三叉神经第1支病变病人术后7 d并发症发生率显著低于射频治疗组(P=0.033),但两组疼痛缓解度无明显差别;对于三叉神经第2、3支病变的病人,术后7 d两组疼痛缓解度和并发症发生率无统计学差异。随访18个月,射频治疗组远期并发症发生率为15%,复发4例;颅后窝手术组远期并发症发生率为3%,未见复发。结论颅后窝探查手术是治疗由三叉神经第1支病变引起的三叉神经痛的良好方法;对于由三叉神经第2、3支病变引起的三叉神经痛,经皮半月节射频热凝术和颅后窝探查手术疗效相当。
Objective To compare the therapeutic effect between percutaneous radiofrequency thermocoagulation of the semilunar ganglion（PRTSG） and posterior fossa exploratory surgery（PFES） for treatment of trigeminal neuralgia（TN）.Methods The treatment outcomes of 126 patients with TN were analyzed retrospectively,60 of whom underwent PRTSG treatment and 66 underwent PFES treatment.Results The postoperative efficacy rate was 91.7% in PRTSG group and 86.4% in PFES group.In the patients with lesions in the first branch of trigeminal nerve,the complication rate was significantly lower in PFES group than in PRTSG group 7 days after the operation（P=0.033）,while the pain-relief rate showed no significant difference between two groups.In the patients with lesions in the second and third branches of trigeminal nerve,the differences in complication rate and pain-relief rate between the two groups were not statistically significant 7 days after the operation.After a follow-up period of 18 months,the long-term complication rate was 15% and 4 patients recurred in PRTSG group;however,the complication rate was 3% and no recurrence in PFES group.Conclusions PFES is a good method for patients with TN caused by lesion in the first branch of trigeminal nerve.The effects of PRTSG and PFES are similar in the treatment of TN caused by lesions in the second and third branches of trigeminal nerve.
出处
《中国微侵袭神经外科杂志》
CAS
北大核心
2011年第10期462-464,共3页
Chinese Journal of Minimally Invasive Neurosurgery
基金
河北省唐山市科学技术研究与发展计划(编号:09130202A-3-39)
关键词
三叉神经痛
射频热凝术
颅窝
后
显微外科手术
trigeminal neuralgia
radiofrequency thermocoagulation
cranial fossa, posterior
microsurgery
