影响原发性三叉神经痛伽玛刀治疗效果的相关因素分析

目的探讨伽玛刀治疗原发性三叉神经痛的疗效及影响预后的因素。方法回顾性分析75例原发性三叉神经痛的患者行伽玛刀治疗的效果，均经OUR-XGD旋转式伽玛刀治疗，采用4—8mm准直器，半月节照射采用多靶点，三叉神经根照射采用单靶点或双靶点，中心剂量70—90Gy，脑干表面受量〈15Gy。通过随访患者疼痛发作的频率和程度的减轻评价疗效。结果随访时间为3～72个月，平均37．6个月，总有效率90．7％。4例患者2～3年后复发，6例在伽玛刀治疗后半年出现患侧面部麻木感，无其他并发症。经统计学分析，某些因素与疗效相关。结论伽玛刀治疗原发性三叉神经痛一种安全有效的方法，靶点选择、剂量选择、照射部位是影响预后的因素，而病史长短及疼痛分布与预后无相关性。

Analysis of factors influencing effect of gamma knife radiosurgery for idiopathic trigeminal neuralgia

Objective To investigate the effect and prognostic factors of gamma knife treatment for idi-opathic trigeminal neuralgia. Methods Retrospective analysis of 75 cases of patients with idiopathic trigeminal neuralgia were treated by gamma knife,32 cases of male,female 43 cases,have been considered by the OUR-XGD rotating gamma knife treatment,using 4 mm ～8 mm collimator,And a half section exposure multi-target, trigeminal nerve root exposure to a single target or two targets, the center dose of 70 ～ 90 Gy, the brain stem sur-face dose < 15 Gy. Through follow-up of patients with pain onset of the frequency and extent of reduction were e-valuated. Results Follow-up for 3 ～ 72 months, an average of 37.6 months, the total efficiency of 90. 7 %. 4 pa- tients relapse after 2 ～ 3 years, 6 cases had ipsilateral facial numbness after gamma knife treatment in six months, no other complications, the effect of gamma knife radiosurgery for primary trigeminal neuralgia has statis-tical significance with some factor. Conclusions Gamma knife radiosurgery for idiopathie trigeminal neuralgia is a safe and effective method,target selection ,dose selection and irradiated parts are obvious prognostie factors, The history of pain and distribution of the length are no eorrelation with prognosis.