| 杜垣锋,王鼎,沈永锋,孙承龙,王昊,杜权,朱强,俞文华.经皮穿刺球囊压迫治疗三叉神经痛的疗效因素探讨[J].浙江中西医结合杂志,2021,31(11): |
| 经皮穿刺球囊压迫治疗三叉神经痛的疗效因素探讨 |
| Factors that influence the outcome in patients with primary trigeminal neuralgia treated with percutaneous balloon compression of trigeminal ganglion |
| 投稿时间：2021-02-21 修订日期：2021-10-17 |
| DOI： |
| 中文关键词: 三叉神经痛 球囊压迫 预后 |
| 英文关键词:Trigeminal neuralgia Balloon compression Prognosis |
| 基金项目:浙江省医药卫生科技项目(No2021KY229) |
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| 中文摘要: |
| 目的 探讨影响经皮穿刺半月节球囊压迫术治疗原发性三叉神经痛疗效的因素。 方法 回顾性分析我院2015年11月~2018年3月采用经皮穿刺半月节球囊压迫术治疗的200例原发性三叉神经痛患者的临床资料及手术记录,并对患者的疗效进行定期随访,探讨球囊形状、球囊容积、压迫持续时间等参数与患者疗效的关系。结果 术后随访12~40月,平均22.5月。本组术后疼痛即刻消失率92.5%,5%偶尔疼痛,无需服用药物,整体治愈率为97.5%,至随访结束总体有效率为88.5%。术后手术同侧咀嚼肌乏力124例(62%),21例(10.5%)患者出现面部感觉异常,2例(1%)复视(外展神经麻痹),无严重手术并发症发生。分析结果表明,在所有探讨的参数中,球囊形状呈梨形(P<0.001)是影响患者术后疼痛即刻消失及维持患者术后无痛病程的独立预后因素。缩短了球囊的压迫时间后,术后面部感觉异常的发生率明显下降(P=0.035)。结论 球囊形状是影响经皮穿刺半月节球囊压迫术治疗原发性三叉神经痛疗效的决定性参数,在行经皮穿刺球囊压迫术时,应尽量调整球囊位置直至乳头凸向后颅窝的“梨形”出现。 |
| 英文摘要: |
| Objective To evaluate the prognostic factors that could influence the outcome in patients with primary trigeminal neuralgia treated with percutaneous balloon compression of trigeminal ganglion. Methods The clinical data、surgical records and clinical outcomes of 200 patients who underwent percutaneous balloon compression of trigeminal ganglion(PBC) in our hospital from November 2009 to March 2012 were retrospectively reviewed. The possible correlations between the following parameters : balloon shape, balloon volume, compression time were analyzed. Results The immediate pain relief rate was 92.5%, 5% patients had occasional pain, but not required any medication, the overall pain relief rate was 97.5%. The total efficiency was 88.5% with a mean length of follow-up of approximately 22.5 months(12~40moths). Postoperative complications included common side effects such as symptomatic masseter muscle weakness in 124 patients(62%), paresthesia in 21 patients(10.5%), 2 patients(1%) had diplopia secondary to abducens nerve weakness, none of the patients had serious surgical complications. Among the investigated parameters, the analyzed results showed that the pear~like shape of the balloon (P<0.001) was the key prognostic factor which affected the acute pain relief and the pain~free survival after surgery. When Shorten the compression time,the incidence of postoperative facial paresthesia declined obviously(P=0.035). Conclusion Compared with the other surgical parameters, balloon shape is the decisive factor affect the result of percutaneous balloon compression for trigeminal neuralgia, so we should try our best to obtain a pear~shaped balloon with a protrusion toward the posterior fossa. |
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