显微血管减压及神经松解手术治疗颅神经疾病1956例

目的 探讨显微血管减压及神经松解手术治疗颅神经疾病的方法及经验。方法 总结自1986至2005年12月以来局麻下共实施显微血管减压及神经松解手术治疗颅神经疾病1956例，其中三叉神经痛1465例，面肌痉挛428例，舌咽神经痛63例。患者平均年龄62．5岁，病史3至37年不等。介绍了显微血管减压及神经松解手术技巧及术中寻找责任血管及部分神经根切断的注意事项。结果 手术确定了1462例三叉神经痛、428例面肌痉挛和51例舌咽神经痛患者的压迫责任血管，并以teflon垫棉置于其间；对1876例局部蛛网膜和颅神经间的粘连行神经松解手术；对45例行神经根部分切断。手术效果满意。术后总有效率100％。31例复发，其中23例行二次手术治疗后病愈。结论 显微血管减压及神经松解手术是治疗颅神经疾病的有效手段，疗效确切。

Microvascular decompression and nerves relax for 1956 cases of cranial nerves diseases

Objective Try to find out the methods and skills of microvascular decompression and nerve relax for trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia. To evaluate the clinical efficacy and analyze experience. Methods From 1986 to 2004, 1956 operations of microvascular decompressions and nerve relax were performed under local aneasthesia. Cases included 1465 trigeminal neuralgia, 428 hemifacial spasm and 63 glossopharyngeal neuralgia, who had a history from 3 to 37 years and the average age was 62.5. Surgical techniques and methods of the offending vessels searching and partial rhizotomy were analyzed. Results In 1462 trigeminal neuralgia patients, 428 facial spasm patients and 51 glossopharyngeal neuralgia patients, the offending vessels could be identified during the operation. Teflon cotton was interposed between the nerve and the vessels. In 1876 cases, nerve relax was performed to eradicate the adhesion between the arachnoid memnbrane and the cranial nerves involved. In 45 cases, partial rhizotomy was performed. All of the patients had a satisfying curative effect after the procedures, with follow-up period from 6 months to 15 years. However, 31 cases suffered a recurrence, while 23 cases of them had a complete curing after the second operation. Conclusion Microvascular decompression and nerve relax for disease of cranial nerves is excellently successful.