微血管减压术治疗老年性三叉神经痛的临床分析

目的 探讨微血管减压术(MVD)治疗老年性三叉神经痛的效果和安全性.方法 收集大连大学附属中山医院神经外科自2005年1月至2008年6月收治的84例三叉神经痛患者的临床资料,回顾性分析其中29例65岁以上老年患者(老年组)行MVD的疗效及其并发症,并与同期65岁以下患者(对照组)比较.结果 老年组与对照组术后效果均良好,老年组术后疼痛缓解率为93.10%,对照组为96.36%;老年组存在一定的解剖学和身体特征,如有脑萎缩的倾向、责任血管部分动脉硬化明显(老年组约1/4,对照组约1/10)、既往伴有其它全身疾病增多(老年组占71.69%,对照组占41.81%)、术后并发症风险增大的表现(老年组1例术后出现脑十梗死,2例术后出现下肢深血栓栓塞症).结论 结合现代化有效的围手术期处理,用MVD可治愈或缓解老年性三又神经痛.

Microvascular decompression for trigeminal neuralgia in elderly patients

Objective To assess the efficacy and safety of microvascular decompression for treatment of trigeminal neuralgia in elderly patients. Methods The clinical data of29 elderly patients (above 65 years old) with trigeminal neuralgia treated with microvascular decompression were retrospectively reviewed to analyze the outcomes of the surgery and complications in comparison with those of younger patients below 65 years of age. Results Good therapeutic effects were achieved in both groups without obvious difference between them,the rate ofpostoperative pain relieffor the elderly group is 93.10%,96.36%for the control group.The elderly patients showed some special anatomical and systemic features in relation to aging,including the presence of brain atrophy,obvious arteriosclerosis in the culprit arteries(the elderlygroupis about 1/4,the control group is about 1/10),multiple systemic diseases(the elderly group accounted for 71.69%,41.81%for control group),and increased risk of surgical complications(one of the elderly group appears brainstem infarction,2 cases of lower extremity deep VenOUS thromboembolism disease). Conclusion Microvascular decompression provides an effective cure or pain relief for most elderly patients with trigeminal neuralgia with the application of effective perioperative treatment.