周围支撕脱加表阿霉素神经干内注射治疗三叉神经痛的临床分析

目的评价三叉神经周围支撕脱加表阿霉素神经干内注射治疗原发性三叉神经痛（第Ⅲ支）的临床疗效。方法 113例原发性三叉神经痛（第Ⅲ支）患者,随机分为2组,对照组46例行单纯周围支撕脱,治疗组67例行周围支撕脱加表阿霉素神经干内注射,于治疗前及治疗后2周、1个月、6个月、1年和3年,分别对2组患者进行疗效判定。结果术后第2周,2组总有效率差异无统计学意义（χ2=0.010,P=0.900）,但是术后1个月（χ2=7.804,P=0.005）、6个月（χ2=6.875,P=0.009）、1年（χ2=5.114,P=0.024）和3年（χ2=6.566,P=0.010）复查时,试验组的总有效率明显高于对照组,2组差异有统计学意义。对照组复发12例（26.1%）,试验组复发7例（10.4%）,试验组复发率低于对照组。结论三叉神经周围支撕脱加表阿霉素神经干内注射治疗原发性三叉神经痛,疗效较好,并发症较少,安全可靠。

Clinical Evaluation of Trigeminal Neuralgia by Surgical Avulsion and Injecting Epirubicin to the Nerve Trunk

Objective To evaluate the therapeutic effect of surgical avulsion and injection with Epirubicin in the treatment of primary trigeminal neuralgia(Ⅲ).Methods One hundred and thirteen cases of senior primary trigeminal neuralgia(Ⅲ) were separated into 2 groups randomly,control group(n=46): surgical avulsion only;treatment group(n=67): surgical avulsion and injecting epirubicin to the nerve trunk.The pain score of visual analogue scale(VAS) and clinical efficacy were compared and statistically analyzed between the two groups before treatment and 2 weeks,1 month,half of years,1 year,3 year after the operation.Results Two groups had no statistical significance 2 weeks after operation(P>0.05).Compared with the control group,the total effective rate in treatment group was significantly raised in all the patients at 1 month,half of years,1 year,3 year after operation.After statistics analyses(P<0.05),it was significant.Postoperation recurrence of surgical avulsion and injection with Epirubicin was 7 cases(10.4%),it was lower than another group which was 12 cases(26.1%).Conclusion Surgical avulsion and injection with Epirubicin to the nerve trunk in the treatment of primary trigeminal neuralgia has steady therapeutic effect,which is safety and little insult and complication.