伽玛刀对神经根与毗邻血管不同解剖关系的原发性三叉神经痛的治疗疗效分析

目的探讨原发性三叉神经痛患者三叉神经根与毗邻血管的不同解剖关系对伽玛刀治疗疗效的影响。方法回顾性分析2004年1月至2009年1月山西医科大学第二医院伽玛刀中心治疗原发性痛患者82例，依据MR定位影像显示三叉神经根与毗邻血管的不同解剖关系（无接触、可疑接触、明确接触、推移），评估对伽玛刀治疗疗效的影响。结果随访6～18个月，平均随访12．5个月，依据BNI疼痛量表评分Ⅲ级以上70例，总有效率85．4％，三叉神经根与血管无接触组有效率89．7％，可疑接触组有效率86．4％，明确接触78．9％，推移组81．8％，复发8例（9．7％）。结论三叉神经根与毗邻血管的不同解剖关系对伽玛刀治疗疗效差别无统计学意义，推移组复发率较其他组高，远期疗效有待进一步评估。

Assess the effects of different relationships between the root of trigeminal nerve and surrounding vasculars on gamma knife radiosurgery for trigeminal neuralgia

Objective To assess the different trigeminal nerve-blood vessel relationships and its effect on pain relief after gamma knife radiosurgery for trigeminal neuralgia. Methods Review 82 patients treated during January 2004 and January2009, basing on MRI, analyzing trigeminal nerve-blood vessel anatomica relationships and its effects on pain relief. Results All patients had been followed up from 6 to 18 months, median follow-up was 12.5 months., according to Barrow Neurological Institute (BNI)pain scale, success results were achieved in 85.4% patients (no touch89.7%, suspicious touch 86.4%, certained touch78.9%, pushing81.8% ) ,recurrence 9.7%. Conclusion The different trigeminal nerve-blood vessel relationships have no stastical significant on pain relief.Recurrence rate in pushing is higher than the other categories. Gamma knife radiosurgery treatment for classic trigeminal neuralgia is safe and effective, the father effects need faraway research.