三叉神经痛微血管减压术的手术疗效分析

目的探讨微血管减压术（MVD）治疗原发性三叉神经痛（ITN）的手术疗效，总结不同类型责任血管的处理技巧。方法回顾性分析125例接受MVD的ITN的临床资料。对手术操作的要点进行介绍。结果术中见124例三叉神经根部有接触或压迫的血管，占99．2％，最常见的责任血管是小脑上动脉（SCA，占68％）其次为小脑前下动脉（AICA，占30．4％）。动脉性责任血管占96．8％，岩上静脉作为责任血管占8．8％。所有病例均有效（100％），总治愈率为96．8％。结论微血管减压是治疗三叉神经痛安全、微创、有效的方法。提高显微外科操作技巧，不遗漏责任血管，是提高手术疗效和减少并发症的关键。

Analysis on the effect of microvaseular decompression on trigeminal neuralgia

Objective To explore the operative effect of microvascular decompression （MVD） on idiopathic trigemiual neuralgia （ITN） and to summarize the management techniques of the different types of offending vessels. Methods The clinical data of 125 patients with ITN undergoing MVD were analyzed retrospectively. Operative technique and the efficacy were evaluated. Results The offending vessels which were responsible for ITN were identified at root exit zone （REZ） in 124 cases （99. 2% ）. The offending vessels responsible for the compression of trigeminal nerves mostly came from the superior cerebellar artery （SCA） （68%, 85 cases） and anterior inferior cerebellar artery （AICA） （30.4%, 38 cases）. A total of 96. 8% offending vessels were arteries. The main trunk or tributaries of superior petrosal vein contacting with trlgeminal nerve or compressing it occurred in 11 cases （8.8%）. All patients got the initial acute pain relief and the cure rate of 96.8%. Conclusion MVD is a safe, microinvasive and effective surgical modality for ITN. The improvement of operative technique is beneficial to improve the operative effects and reduce the complications of MVD.