锁孔手术治疗脑神经疾病274例分析

目的观察锁孔手术治疗各类脑神经疾病的安全性和疗效。方法采用锁孔手术治疗各类颅神经疾病274例．其中26例继发于颅内肿瘤的三叉神经痛患者行肿瘤切除，248例原发性脑神经疾病患者行微血管减压手术，并对手术方法进行了一定的改良。结果26例继发性三叉神经痛患者21例疼痛停止，3例减轻，2例无效：三叉神经痛微血管减压手术的早期疗效为95．7％，远期疗效为94.5％；面肌痉挛的早期疗效为94.2％，远期疗效为92．8％；7例舌咽神经痛患者疗效满意。结论锁孔手术对减少手术创伤有重要意义；微血管减压术是治疗各类原发性脑神经疾病的安全、有效方法，在各类脑神经疾病的发生中，异位血管压迫脑神经起重要作用，手术方式的改良有益于提高手术疗效和减少并发症的发生。

The treatment of cranial pathies with microvascular decompression by key hole approach:a retrospective study of 274 consecutive operated cases

Objective To observe the safety and efficacy of cranial neuropathies by key hole approach.Methods Of all the 274 patients treated by key hole approach,26 trigeminal neuralgia attributed to tumor had tumor cut,the other 248 cranial nerve idiopathy had microvascular decompression,and the operation was improved in its approach and the methods to isolate microvessels and nerves.Results For all the 26 subsequent trigeminal neuralgia,21 was successful,3 was brought about improvement,and only 2 failed.The early cure rate in trigeminal neuralgia with microvascular decompression is 95.7%,later rate is 94.5%;in hemifacial spasm early is 94.2%,later is 92.8%;7 with glossopharyngeal neuralgia.Conclusion The operation by key hole approach can improve safety and reduce injury.Microvascular decompression is a safe and effective operation for cranial nerve idiopathy.Offending vessels compressing on cranial nerve play an important role in the rise of cranial nerve idiopathy based on the Neurovascular Conflict theory.The improvement of operation is beneficial for increasing cure rate and preventing complication.