显微血管减压术治疗三叉神经痛长期疗效研究

目的研究显微血管减压术（microvascular decompression，MVD）治疗三叉神经痛的长期效果。方法回顾性分析482例三叉神经痛病人的临床资料，均接受MVD治疗，随访时间5年以上，电话或门诊随访。结果术后疼痛消失419例，术后即刻疼痛消失率86．9％，部分病人有短暂可逆性并发症，包括疱疹病毒感染、面部麻木、周围性面瘫、耳鸣和听力下降。随访时间5—12年，失访24例；出院时疼痛消失的病人在随访期间复发38例，其中5年内复发24例，5年以上复发14例，复发率9．5％。结论MVD是目前惟一针对三叉神经痛病因进行治疗的手术方式，手术后三叉神经的运动和感觉功能完好保留，其长期疗效良好。

A long term efficacy of microvascular decompression for trigeminal neuralgia

Objective To investigate the long term outcome of microvascular decompression （MVD） for trigeminal neuralgia. Methods The data of 482 patients with trigeminal neuralgia were analyzed retrospectively. All the patients were treated by MVD and followed up by telephone or clinic service, for above 5 years. Results The pain disappeared in 419 cases after operation, and pain disappearance rate was 86.9%. Some patients had transient complications, including herpes virus infection, facial numbness, peripheral facial palsy, tinnitus and hearing loss. The follow-up period ranged from 5 to 12 years, and 38 patients （24 for 5 years and 14 for more than 5 years） experienced recurrence of pain during the following-up period, with a recurrence rate of 9.5%. Conclusion MVD is an only etiological strategy for trigeminal neuralgia, and the nervous function can be maintained well. The long-term outcomes of MVD are good in majority oftrigeminal neuralgia patients.