摘要
目的：总结经皮穿刺球囊压迫半月神经节手术（PBC）治疗顽固性三叉神经痛的临床效果。方法：对我科自2009年10月至2013年5月采用PBC方法治疗的452例顽固性三叉神经痛患者的临床资料进行回顾性总结,其中80岁以上高龄患者125例,疼痛累及第Ⅰ支70例;PBC在X线监视下应用Hartel前入法、通过鞘管导入4号Fogarty球囊进入Meckel腔压迫半月节,术后对患者进行随访及疗效观察。结果：本组患者术后住院3~9 d,平均6.1 d,无严重手术并发症发生。432例术后疼痛完全缓解,总有效率为97.8%,术后患者感患侧面部麻木385例（85.2%）,张口咀嚼略乏力248例（54.9%）,口角疱疹139例（30.8%）,复视2例（0.4%）,症状多于1~6个月内好转或消失。平均随访23.5个月,本组疼痛复发率约为10.2%（46例）。结论：PBC是治疗顽固性三叉神经痛十分有效的微创手术方法 ,尤其对于高危或疼痛累及第Ⅰ支、各种手段治疗后复发的患者更有优势。
Objective To evaluate the clinical effects of percutaneous micro-balloon compression （PBC） trigeminal ganglion for the treatment refractory trigeminal neuralgia. Methods Surgical results of 452 patients with trigeminal neuralgia treated by PBC from October 2009 to May 2013 were analyzed retrospectively. 125 cases aged over 80 years old and 70 cases′ pain belongs to the first branch neuralgia. Such procedures as Meckle′s cave cannulated with No.4 Forgarty catheter and the balloon inflated and compressed the gasserian ganglion monitored by X-ray were observed by PBC. Follow-up interview and curative effects were recorded. Results The average hospitalization was 6.1 days. Among them, 432（95.6%） cases had immediate relief from pain. The overall pain relief rate was 97.8% in our group without serious surgical complications. Postoperative complications include hemifacial numbness in 385 patients （85.2%）, mild masseter muscle weakness in 248 patients （54.9%）, diplopia in 2 patients. All symptoms relived or disappeared within 1 ~ 6 months. The average follow-up intervier period is 23.5 months. The recurrence rate is 10.2% （46 cases）. Conclusion PBC is a safe and effective method with high pain relief rate in the treatment of refractory trigeminal neuralgia , especially for the treatment of the high risk patients , patients with recurrent symptoms or the patients suffered from the first branch neuralgia.
出处
《实用医学杂志》
CAS
北大核心
2014年第21期3395-3397,共3页
The Journal of Practical Medicine
基金
浙江省科技计划项目(编号:2013C33092)
浙江省医药卫生科技计划项目(编号:2011KYB064)
杭州市科技计划项目(编号:20110833B04)
关键词
三叉神经痛
球囊
压迫
Trigeminal neuralgia
Balloon
Compression
