摘要
目的探讨数字减影血管造影/CT引导下经皮穿刺三叉神经节微球囊短时间、重复压迫术(PMC)治疗原发性三叉神经痛的疗效。方法收集2017年11月至2018年11月在青岛市市立医院疼痛科住院的原发性三叉神经痛患者20例,年龄≥18岁,性别不限。按随机数字表法分为经皮穿刺微球囊单次压迫术治疗组(OPMC组)与经皮穿刺微球囊压迫术短时间三次压迫治疗组(TPMC组),各组10例。OPMC组在PMC治疗过程中,球囊采用单次压迫三叉神经,压迫时间3 min;而TPMC组在PMC治疗过程中球囊三次压迫三叉神经,每次压迫时间60 s。采用简化麦吉尔评分(SF-MPQ)、视觉模拟评分(VAS)及匹兹堡睡眠质量指数评分(PSQI)在术前及治疗后3 d、10 d、1个月、3个月、6个月、12个月对患者进行疗效对比;采用巴罗神经研究所面部麻木评分(BNI)对两组患者术后的面部感觉障碍进行评价。结果与治疗前比较,两组患者治疗后SF-MPQ、VAS及PSQI评分均降低(P均<0.05),但两组间比较差异无统计学意义(P均>0.05)。与治疗后3 d相比,两组患者在治疗后10 d、1个月、3个月、6个月、12个月BNI评分逐渐降低(P均<0.05),而TPMC组患者在治疗后10 d、1个月、3个月、6个月、12个月的BNI评分均明显低于OPMC组(P均<0.05)。所有患者面部感觉障碍均在术后1年内逐步恢复或耐受。结论DSA引导下PMC两种压迫方法均能有效治疗原发性三叉神经痛。其中短时间、重复压迫法面部麻木较轻。
Objective To investigate the efficacy of short time and repeated percutaneous microballoon compression(PMC)under the guidance of digital subtraction angiography(DSA)in the treatment of trigeminal neuralgia(TN).Methods Twenty patients with TN aged≥18 years old,both sexes,were collected in Pain Department of Qingdao Municipal Hospital from November 2017 to November 2018.All patients were divided into two groups(n=10):single time compression therapy group of PMC(group OPMC)and three times compression therapy group of PMC(group TPMC)according to random number table.The balloon was deflated and withdrawn after compressing the trigeminal nerve for 3 min in group OPMC;while alternating 3 cycles of 60 s inflation and 60 s deflation for trigeminal nerve compression in group TPMC.The short-form McGill pain questionnaire(SF-MPQ),visual analogue scale(VAS)and Pittsburgh sleep quality index(PSQI)were used for evaluation of pain degree and sleep quality before the treatment and 3 d,10 d,1 month,3 months,6 months,12 months after the treatment.Barrow neurological institute(BNI)facial numbness scoring system was used to assess facial sensory impairment.Results Compared with pretreatment,the SF-MPQ,VAS and PSQI of two groups were significantly reduced at different time points after the treatment(all P<0.05),there was no difference between the two groups(all P>0.05).Compared with 3 d after the treatment,the BNI facial numbness scores of the two groups were significantly decreased at the other time points after the treatment(all P<0.05),and the BNI facial numbness scores of group TPMC were significantly lower than those of group OPMC(all P<0.05).All patients reported that their facial numbness had fully resolved in the two groups after one year.Conclusion Good effects can be achieved by the two different compression methods of PMC with the guidance of DSA/CT,but with slighter facial numbness with short time and repeated compression method.
作者
王蕊
唐玉茹
陈付强
Wang Rui;Tang Yuru;Chen Fuqiang(Department of Pain Management,Municipal Hospital of Qingdao,Qingdao City,Shandong Province,266011,China;Department of Special Inspection Section,Qingdao Mental Health Center of Shandong,Qingdao University,Qingdao City,Shandong Province 266034,China)
出处
《中华疼痛学杂志》
2020年第1期36-42,共7页
Chinese Journal Of Painology
关键词
三叉神经痛
三叉神经节
经皮微球囊压迫术
数字减影血管造影
Trigeminal neuralgia
Trigeminal ganglion
Microballoon compression
Digital subtraction angiography
