下牙槽神经、舌神经干注射阿霉素联合颊神经撕脱治疗第Ⅲ支三叉神经痛的疗效观察

目的:评价下牙槽神经、舌神经干注射阿霉素联合颊神经撕脱治疗三叉神经(Ⅲ支)痛的疗效。方法:对41例三叉神经痛患者进行单纯下牙槽、舌神经干注射阿霉素的治疗,52例进行神经干注射阿霉素联合颊神经撕脱治疗。对2组术后3a、5a的复发率进行χ2检验。结果:单纯注射阿霉素组,37例疼痛症状消失,4例症状缓解;联合颊神经撕脱组,52例疼痛症状全部消失。随访3a,前者的复发率为12.2%,后者为3.8%(P>0.05);随访5a,前者的复发率为21.9%,后者为5.8%(P<0.05);随时间延长,2组间的复发率差异加大。结论:神经干注射阿霉素联合颊神经撕脱术,可提高神经干注射阿霉素治疗三叉神经(Ⅲ支)痛的疗效,减少其复发率。

Evaluation of the clinical therapeutic efficacy by injecting adriamycin to the inferior alveolar and lingual nerve and avulsion of the buccal nerve in primary trigeminal neuralgia

PURPOSE: To evaluate the clinical therapeutic efficacy by injecting adriamycin to the inferior alveolar and lingual nerve and avulsion of the buccal nerve in primary trigeminal neuralgia (the third branch). METHODS: Adriamycin was injected to the lingual nerve and inferior alveolar nerve in primary trigeminal neuralgia of 41 cases; adriamycin injection combined with avulsion of the buccal nerve was applied in another 52 cases of primary trigeminal neuralgia. The recurrence rate for 3 years and 5 years was analyzed by Chi- square test. RESULTS: In the group of injection of adriamycin, the symptom of pain disappeared in 37 patients and decreased in 4 patients after treatment. The recurrence rate was 12.2% in 3 years and 21.9% in 5 years. In the group of combined treatment, the symptom of pain disappeared in all cases. The recurrence rate was 3.9%(P>0.05) in 3 years and 5.8% (P<0.05) in 5 years. The difference of recurrence rate between the two groups increased with the lapse of time. CONCLUSION: Combined injection of adriamycin to the nerve trunk and avulsion of the buccal nerve in primary trigeminal neuralgia can improve the therapeutic efficacy,and decreased recurrence.