三叉神经痛不同术式疗效分析：附178例报告

目的 :观察比较三叉神经痛三种不同手术方式的疗效。方法 :采用经颞硬膜外三叉神经感觉根切断术 ,经皮三叉神经半月节射频热凝术和三叉神经显微血管减压术治疗 178例患者 ,对其疗效、不良反应和复发率进行评估。结果 :感觉根切断术组 :疗效尚好 ,不良反应中面部感觉障碍发生率较高 ,易误伤运动根 ,也较易复发 ;射频热凝术组 :简单、安全、有效 ,面部感觉障碍发生率较低 ,唯复发率较高 ;血管减压术组 ;疗效肯定 ,不良反应少 ,复发率低 ,但手术风险相对较大。结论 :三叉神经感觉根切断术逐渐少用。射频热凝术适用于年老体弱 ,不能耐受手术及首次外科治疗者。对于射频热凝术后复发者 ,可酌情行显微血管减压术。

The effective analysis of different surgical procedures for the management of trigeminal neuralgia

Objectives:To investigate and contrast the curative effect of three kinds of surgical procedures for the management of trigeminal neuralgia.Methods:One hundred and seventy-eight consecutive patients with trigeminal neuralgia were divided into 3 groups and treated with transtemporal extradural approach for section of root of trigeminal nerve (14 cases),percutaneous radiofrequency thermocoagulation of the gasserian ganglion (140 cases),and microvascular decompression (24 cases) respectively.The effect,adverse reaction and pain recurrent rate were assessed.Results:In the section of sensory root group,the curative effect was relative good.Incidences of facial sensory disturbance and motor root injuried by mistake were common relatively.Recurrent rate was higher either.Radiofrequency thermocoagulation was a simple,safe and effective method.Incidence of facial sensory disturbance was lower but recurrent rate was still relative higher.In the microvascular decompression group,the curative effect was very good,side-effect was uncommon and incidence of recurrence was lower,but surgery risk was relative higher.Conclusions:Gradually,section of sensory root of trigeminal nerve was inclined not to be applied.Radiofrequency thermocoagulation was suited for the aged,unable to tolerate operation and surgery treatment first.The patients of recurrence after radiofrequency thermocoagulation may undergo microvascular decompression considerately.