三叉神经半月节射频热凝治疗后复发原因分析及对策

目的分析原发性三叉神经痛立体定向射频热凝治疗后复发的原因及对策。方法回顾性分析2008年9月-2012年12月在我科接受立体定向射频热凝治疗的原发性三叉神经痛病人213例，其中复发病例15例，11经改变射频条件再次对其行射频毁损，4例行微血管减压术，分析手术复发的原因及对策。结果11例患者再次射频毁损治疗，9例患者术后面部疼痛消失；2例术后一周内逐步缓解。另外4例行微血管减压治疗，术后面部疼痛均缓解，其中1例患者术后出现面部麻木感，经积极治疗后逐步缓解。结论卵圆孔偏大、毁损温度低是导致射频热凝术术后复发的主要原因，责任血管持续压迫次之，术前严格把握适应证、选择适当的射频条件可以减少手术复发率。

The cause analysis and countermeasure of recurrent trigeminal neuralgia after radiofrequencytherapy

Objective To investigate the cause and countermeasures of recurrent trigemi- nal neuralgia after stereotaetic radiofrequeney thermocoagulation. Methods Retrospective analy- sis of stereotactic radiofrequency therapy of primary trigeminalneuralgia patients 213 cases in 2008 September to 2012 December in our department, 15 eases of recurrence, 11 with varying conditions are againradiofrequeney lesion, 4 cases underwent microvascular decompression, Analysis of the cause of relapse and seek countermeasures. Results 11 patients underwent radiofrequency treat- ment again, 9 cases the pain disappeared after operation; 2 patients were gradually alleviated in one week after the operation; The other 4 cases underwent microvascular decompression, facial pain were relieved after operation; 1 people feel facial numbness after operation, but after treatment have been gradually eased. Conclusion Large oval foramen and low temperature damage is the main cause of radiofrequercy thermocoagulation of postoperative recurrence, Responsible vessels continued compression as a secondary cause. Preoperative strictly grasp the indications, select the appropriate RF conditions can reduce the recurrence rate of operation.