摘要
目的探讨单纯神经内镜与显微镜下血管减压术治疗颅神经疾病的安全性和有效性。方法回顾性分析2014年1月至2016年9月该院260例行血管减压术的颅神经疾病患者的临床资料,根据患者手术方式进行分组,内镜组138例经乙状窦后进路在神经内镜下进入桥小脑角区,探查相关区域有无异常血管或其他病灶压迫情况,对责任血管进行推移减压、垫片、分解粘连等治疗,显微镜组122例行传统乙状窦后入路显微血管减压术手术。所有手术均由同一术者完成,术后随访1年。结果术后症状立即消失的患者内镜组137例(99.28%),显微镜组120例(98.36%);术后1年治愈的患者内镜组124例(89.86%),显微镜组108例(88.52%);听力下降的患者内镜组2例(1.45%),显微镜组5例(4.10%);面部浅感觉减退的患者内镜组5例(3.62%),显微镜组8例(6.56%);短暂性共济失调的患者内镜组3例(2.17%),显微镜组5例(4.10%);脑脊液漏的患者内镜组3例(2.17%),显微镜组3例(2.46%);口周疱疹的患者内镜组23例(16.67%),显微镜组27例(22.13%)。两组均未出现颅内感染、死亡、面瘫、脑内出血。两种手术治疗临床效果及并发症比较差异均无统计学意义(P>0.05)。结论单纯神经内镜下血管减压术不能获得更高的手术治愈率,但能减少对脑组织的牵拉,从而减少部分手术并发症。
Objective To compare the safety and effect of microvascular decompression completely under endoscopy-assisted or microscope-assisted for trigeminal neuralgia.Methods A retrospective analysis was conducted for 260 patients who underwent microvascular decompression from January 2014 to September 2016.They were divided into two groups according to the surgical techniques,138 patients in the endoscopic group underwent sigmoid sinus approach to enter the cerebral cerebral horn area under neuroendoscopy,explored whether there were abnormal blood vessels or other lesions in the relevant area,and the treatment of the responsible vessels was performed with decompression,shims,decomposed adhesions.While 122 cases in the microscope group were operated according to the traditional sigmoid sinus approach for microvascular decompression.All the operations were performed by the same surgeon.The patients were followed up for 1 year.Results 137 cases(99.28%)postoperative symptoms disappeared immediately in the endoscopy group and 120 cases(98.36%)in the microscope group;124 cases(89.86%)healed 1 year after surgery in the endoscopy group and 108 cases(88.52%)in the microscope group;2 cases(1.45%)hearing decreased in the endoscopy group and 5 cases(4.10%)in the microscope group;5 cases(3.62%)had facial hypoesthesia in the endoscopy group and 8 cases(6.56%)in the microscope group;in the endoscopy group 3 cases(2.17%)had transient ataxia and 5 cases(4.10%)in the microscope group;in the endoscopy group 3 cases(2.17%)had cerebrospinal fluid leakage and 3 cases(2.46%)in the microscope group;23 cases(16.67%)had oral herpes in the endoscopy group and 27 cases(22.13%)in the microscope group.There were no intracranial infections,death,facial paralysis or intracerebral hemorrhage in both groups.There was no significant difference in clinical outcomes and complications between the two surgical treatments(P>0.05).Conclusion Complete endoscope-assisted microvascular decompression could not achieve higher surgical cure rate,while it can reduce t
作者
向晖
冷景兴
刘如恩
XIANG Hui;LENG Jingxing;LIU Ruen(Department of Neurosurgery,Jiangxi Provincial People′s Hospital,Nanchang,Jiangxi 330006,China)
出处
《重庆医学》
CAS
2018年第31期3991-3993,3997,共4页
Chongqing medicine
基金
江西省科技厅重点研发计划(20161BBG70119)
关键词
神经内镜
显微镜
颅神经疾病
血管减压术
neuroendoscope
microscope
cranial nerve disease
microvascular decompression
