摘要
目的探讨C臂引导下个体化确定穿刺点在半月节射频治疗三叉神经痛中的有效性及适用性。方法回顾性分析采用Hartel前入路半月节射频治疗的203例三叉神经痛病人的临床资料,分为C臂组(n=87)和O臂组(n=116)。其中C臂组病人采用C臂个体化确定穿刺点,O臂组病人采用O臂三维重建定位。记录投照次数、手术时间、随访术后疼痛改善及并发症情况,比较两组病人的穿刺准确率和手术有效率。结果 C臂组投照3~11次,手术有效率82.8%,穿刺准确率65.5%;O臂组投照1~5次,手术有效率79.3%,穿刺准确率61.2%;两组在手术时间、穿刺准确率、手术有效率方面的差异无显著统计学意义(P>0.05)。两组病人均无角膜溃疡、感染、颅内出血、永久咀嚼肌无力等严重并发症。结论 C臂个体化确定穿刺点,经卵圆孔长轴穿刺半月节,操作便捷,可调节性高。与O臂定位比,C臂定位准确率及手术有效率相当,临床实用性较好。
Objective To investigate the efficacy and applicability of the individualized puncture point location under C-arm guidance in gasserian ganglion radiofrequency for trigeminal neuralgia. Methods Clinical data of 203 patients with trigeminal neuralgia who underwent gasserian ganglion radiofrequency via Hartel anterior approach were analyzed retrospectively, who were divided into C-arm group(n = 87) and O-arm group(n = 116). The individualized puncture point was located under the guidance of C-arm in C-arm group and three dimensional reconstruction of location under the guidance of O-arm was performed in O-arm group. The intraoperative imaging projection times, surgical duration, postoperative pain relief and complications were recorded. The accuracy of puncture and the surgical response rate were compared between the two groups. Results The intraoperative imaging projection times were 3 to 11 times, the surgical response rate was 82.8% and puncture accuracy was 65.5% in C-arm group. The intraoperative imaging projection times were 1 to 5 times, the surgical response rate was 79.3% and puncture accuracy was 61.2% in C-arm group. There was no significant difference in surgical duration, puncture accuracy and the surgerical response rate between the two groups(P > 0.05). No severe complications such as corneal ulcer, infection, intracranial hemorrhage, permanent weakness of masticatory muscle occurred in the two groups. Conclusions The individualized punture point is located under C-arm guidance and then the gasserian ganglion is punctured through the long axis of the foramen ovale, which is convenient and highly adjustabe. In terms of puncture accuracy and surgical response rate, C-arm is as good as the O-arm and shows good clinical practicability.
作者
倪兵
胡永生
卢光
舒伟
朱宏伟
Ni Bing;Hu Yongsheng;Lu Guang;Shu Wei;Zhu Hongwei(Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)
出处
《中国微侵袭神经外科杂志》
CAS
2019年第7期310-313,共4页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
三叉神经痛
三叉神经节
射频
C臂
O臂
定位
trigeminal neuralgia
trigeminal ganglion
radiofrequency
C-arm
O-arm
location
