二次经皮穿刺球囊压迫治疗初次球囊术后复发性三叉神经痛

目的探讨二次经皮穿刺球囊压迫(percutaneous balloon compression,PBC)治疗初次PBC术后复发性三叉神经痛的临床疗效。方法回顾性分析了64例采用二次PBC治疗初次PBC术后复发性三叉神经痛患者的临床资料及疗效。结果术后疼痛即刻缓58例(90.6%),偶有疼痛但不需服药者3例(4.7%),疼痛未消失但服药可控制者2例(3.1%),较术前有所缓解但服药不能控制者1例(1.6%),整体有效率为95.3%。随访至今(2~63个月,平均随访时间2年以上),6例轻度复发,2例重度复发,2年复发率12.5%。术后患侧面部麻木60例(93.8%),咀嚼肌乏力36例(56.3%),口角疱疹29例(45.3%),无角膜溃疡、蛛网膜出血及其他严重并发症。结论二次PBC治疗初次PBC术后复发的三叉神经痛具有风险小、疗效好、复发率低的优点,是其较理想手术方案选择。

Percutaneous Balloon Compression of Trigeminal Ganglion for Recurrent Trigeminal Neuralgia after Percutaneous Balloon Compression

Objective To evaluate the clinical effects of the patients with recurrent trigeminal neuralgia after percutaneous balloon compression treated with percutaneous balloon compression of trigeminal ganglion. Methods A total of 64 patients underwent a second PBC, and a retrospective study of the clinical data of these patients was performed. Results After PBC, pain relief was immediate in 58(90.6%) patients, and 3(4.7%) patient had some pain and need no medication, 2(3.1%)patients had some pain that could be controlled with medication. The total efficiency was 95.3%. With a mean length of follow-up of approximately 2 years after surgery, 6 cases had mild recurrence, 2 cases suffered severe recurrence. Postoperative morbidity included common side effects such as facial numbness in 60(93.8%) patients, masseter muscle weakness in 36(56.3%) patients, herpes in 29(45.3%) patients. No corneal anesthesia, subarachnoid hemorrhage or other serious surgical complications occurred in this study. Conclusion Repeated PBC is a minimally invasive, safe and low recurrent procedure which takes as an attractive choice for recurrent trigeminal neuralgia after PBC.