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桥小脑角区显微手术治疗三叉神经痛101例
引用本文:毛更生 张蕴增. 桥小脑角区显微手术治疗三叉神经痛101例[J]. 武警医学, 1999, 10(9): 505-508
作者姓名:毛更生 张蕴增
作者单位:武警总医院神经外科!北京100039(毛更生,张蕴增,杜长生),白求恩医科大学附属第一临床学院神经外科(吴耀晨,赵刚)
摘    要:目的 介绍101 例三叉神经痛经桥小脑角显微手术治疗经验。方法 分析101 例三叉神经痛的病因、术式选择及复发率,并就减少并发症进行探讨。结果 3 例胆质瘤切除术后三叉神经痛症状均消失。余98 例术后疼痛即刻消失者88 例;10 例仍疼痛但程度减轻,均存在于62 例行微血管减压术式者中,其中5 例于术后10 d 内疼痛消失,另5 例口服药物可控制。近期有效率100 % ,近期治愈率898 % 。无死亡病例。共随访成功65 例,随访时间05 ~7 a ,复发6例。结论 治疗三叉神经痛的桥小脑角区显微是最接近其病因的治疗,并视术中情况进一步实施微血管减压术或感觉根部分切断术,是治疗三叉神经痛较理想的手术。

关 键 词:三叉神经痛  桥小脑角  显微手术  微血管减压术  感觉根部分切断术

Microsurgical treatment of trigeminal neuralgia in cerebellopontine angle
Abstract:Objective To introduce the microsurgical experience in treatrnent of trigeminal neuraglia in cerebellopontine angle of101 cases . Methods Etiology ,operative methods and recurrence rate ofthe disense are analyzed . The way to decrease complications isalso discussed . Results Ofthese 101 patients ,3 with cholesteatoma removaed sugically had no recurrence of pain ,88 obtained im medi ate virtually complete relief ofthe trigeminal neuralgia postoperatively ,and 10 ,who part ofthe 62 receiving microvascular decompression,stiu had pain butless severe than preoperatively . In the latter,5 had no recurrence of pain within 10 days ,5 had pain well controlledwith carbamazepine . The early effective rate was 100 % ,and the early postoperative cure rate was 89 .8 % ,withoutfatalitg . There were 6with recurrence of pain in 65 who were followed up for 0 .5 to 7 years . Conclusion The microsurgery in cerebellopontine angleisthera peutic procedure in based on in etiology . In the light of concrete conditions ofthe procedure the microvascular decompression of partialsensory rhizotomy wasfurther performed on a patient. Microsurgicaltreatmentfortrigeminal neuragliain the cerebellopontine angle isrec ommended as a satisfactory procedure(operative) for patients with trigeminal neuralgia who are surgical candidates .
Keywords:Trigeminal neuralgia Cerebellopontine angle Microneurosurgery Microvascular decompression Partial sensoryrhizotom
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