伽玛刀治疗原发性三叉神经痛50例疗效分析

目的评价伽玛刀治疗原发性三叉神经痛的安全性，有效性和预后因素。方法原发性三叉神经痛50例接受了伽玛刀治疗，治疗部位位于三叉神经根近脑干侧，采用4mm准直器，双靶点治疗，周边剂量：35-40Gy；中心剂量：70-80Gy。结果随访：10-40个月（平均18个月）；术后疼痛缓解时间：1天～20个月（平均3．5个月）；总有效率为总有效率为90％（45／50）；面麻3例；并发症发生率为6％。结论伽玛刀治疗三叉神经痛安全有效，并发症少，在达到有效治疗剂量（70-90Gy）的同时，适当扩大照射体积可能提高疗效。

Clinical study on treatment to primary trigeminal neuralgia with gamma knife radiosurgery in 50 cases

Objective The aims of this study gamma knife in the treatment of primary trigeminal were to assess the efficacy and effectiveness of neuralgia and to analyze the prognostic factors among the cases. Methods 50 patients who received gamma knife treatment were analyzed in this study. The treatment area was located in the root of trigeminal nerve and closed to the brain side. And the 4ram collimator and double target treatment were used in the treatment. The peripheral dose was 35-40 Gy and central dose was 70-80 Gy. Results All patients were followed up for 10-40 months （average： 18 months）. The postoperative pain relief time was ld-20 months （average 3.5 months）. The total effective rate was 90% and the incidence rate of complication was 6- inculding three surface anesthesia cases. Conclusion Gamma knife radiosurgery is effective and safe for trigeminal neuralgia patients. When the treatment reach to the effective dose, which is about 70-90 Gy, the efficacy may enhance after enlarging the treatment area gently.