提高颅神经显微血管减压术疗效的临床研究(附1950例报告)

目的探讨微血管减压术治疗三叉神经痛、面肌痉挛、舌咽神经痛方法的改进措施和提高治疗效果的临床经验.方法自1984年12月至2004年6月采用微血管减压术治疗1950例颅神经血管压迫综合征病例,其中三叉神经痛1 515例,面肌痉挛400例,舌咽神经痛35例.结果全部病例术中均发现有明确的压迫血管,总有效1 886例,有效率为96.7%,无死亡病例.由于显微外科技术的应用及手术技巧的提高,并发症发生率由8年前的10.55%下降到近8年的2.88%.结论显微血管减压术是三叉神经痛、面肌痉挛和舌咽神经痛最有效的治疗方法.术中颅神经根部的显露、责任血管的识别及减压材料的放置等是影响手术效果的关键.提高微血管减压术的治愈率、减少并发症及复发率有多方面因素值得考虑.

Clinical research on the microvascular decompression in the treatment of cranial nerve and vascular compression syndromes: report of 1 950 cases

Objective To study the possible means to improve microvascular decompression (MVD) in the treatment of such cranial nerve and vascular compression syndromes as trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia. Methods A systematic review was made for 1 950 cases (1 515 of trigeminal neuralgia, 400 of hemifacial spasm and 35 of glossopharyngeal neuralgia) who underwent from December 1984 to June 2004 microvascular decompression for the treatment of cranial nerve and vascular compression syndromes. Results The offending vessels can be identified in all cases. The number of cases with satisfactory effects is 1 886 with an effective rate of 96.7%, and no case died in this group. The complication rate dropped from 10.55% of 8 years ago to 2.88% of the recent 8 years. Conclusion MVD operation is the most available treatment to the trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia. The key points of the MVD operation include good exposure of REZ, correct identifying of the OV, and proper positioning of Teflon grafts. Various factors need to be considered in order to elevate the cure rate and decrease the possible complications of microvascular decompression.