摘要
目的探讨微血管减压术治疗原发性三叉神经痛合并高血压患者的疗效及磁共振断层血管成像(MRTA)术前评估的意义。方法回顾性分析微血管减压治疗的26例伴有高血压病的原发性三叉神经痛患者的临床资料,所有患者术前均行MRTA检查评估三叉神经及延髓与周边血管的关系并行微血管减压术,术后监测三叉神经痛症状、血压改变。结果所有患者MRTA资料均清晰地显示患侧三叉神经的走形,再现桥小脑角区三叉神经与血管的解剖结构。术后所有患者三叉神经痛症状均消失,18例左侧三叉神经痛患者随访3个月时17例(94.4%)血压治愈、1例显效;8例右侧三叉神经痛患者随访3个月时血压治愈2例、显效2例、有效1例、无效3例。结论 MRTA能清晰地显示三叉神经与周围血管的解剖关系,对临床医师在进行术前评估提供了有用的术前影像资料,有助于设计手术计划、优化手术操作。异常血管袢压迫三叉神经及左侧延髓腹外侧,长期疼痛刺激和情绪紧张是神经性高血压的病因,微血管减压术是治疗原发性三叉神经痛并发高血压的有效方法。
Objective To evaluate the efficacy of microvascular decompression （MVD） in patients with idiopathic trigem- inal neuralgia （ITN）, and to discuss the value of magnetic resonance tomographic angiography （MRTA） in the preoperative as- sessment of MVD. Methods In total, 26 cases of ITN associated with hypertension treated with MVD were retrospectively ana- lyzed, all the cases were treated with MVD in the zone of the ventrolateral medulla oblongata and inspected for postoperative blood pressure. The preoperative MRTA images for 26 patients with ｜TN associated with hypertension was analyzed retrospec- tively. All the cases were treated with MVD, and inspected for postoperative symptoms of trigeminal neuralgia and blood pres- sure. Results The MRTA could clearly show the relationship between the trigeminal nerve and blood vessels. All patients were followed up for three months. The symptoms of trigeminal neuralgia of all patients disappeared. Among 18 patients of left tri- geminal neuralgia, the blood pressure of 17 patients had cure result, 1 patients had obvious effectiveness. Among eight patients of right trigeminal neuralgia, the blood pressure of two patients had eure result, two patients had obvious effectiveness, one patient had effectiveness, and three patients had noeffeetiveness. Conclusion MRTA may allow clear visualization of spatial re- lationship of trigeminal nerves and surrounding vascular structures, it may also provides reliable imaging for designing operations plan and optimizing MVD procedures. The abnormal vascular tab presses trigeminal nerve and left ventral ventrolatenal medulla. Long term pain stimulation and emotionaltension are the causes of neurogenic hypertension. It is an effective method to treat ITN associated with hypertension with MVD in this zone.
出处
《福建医药杂志》
CAS
2018年第1期32-35,共4页
Fujian Medical Journal
关键词
三叉神经痛
高血压
磁共振断层血管成像
微血管减压术
trigeminal neuralgia
hypertension, magnetic resonance tomographic angiography
microvascular decompression
