摘要
目的探讨术中螺旋CT三维重建辅助下卵圆孔定位的优势,总结经皮穿刺三叉神经半月节经皮球囊压迫术(percutaneous balloon compression,PBC)治疗顽固性三叉神经痛(trigeminal neuralgia,TN)的安全性及疗效。方法回顾性分析30例顽固性TN病例资料,均采用术中螺旋CT引导下PBC治疗。结果术后疼痛完全缓解25例(BNIⅠ级),疼痛明显好转3例(BNIⅡ级),部分好转2例(BNIⅢ级+Ⅳ级),有效率为93.3%(28/30)。病侧面部麻木发生率93.3%(28/30),咀嚼乏力33.3%(10/30),耳鸣3.3%(1/30),麻木等不适症状多在1~3个月内明显好转或消失,不影响生活,无严重手术并发症的发生。随访期内复发2例,近期疼痛复发率约为6.7%(2/30)。结论PBC治疗TN临床效果确切,创伤小,风险低,尤其对于高危、疼痛累及第Ⅰ支、复发的病人更有优势。术中采用3D-CT引导,定位准确,降低风险。
Objective To explore the advantages of intraoperative spiral CT three-dimensional reconstruction assisted positioning of the foramen ovale,and summarize the safety and efficacy of percutaneous balloon compression(PBC)for the treatment of refractory trigeminal neuralgia(TN).Methods The clinical data of 30 patients with refractory TN were analyzed retrospectively,all of whom were treated with intraoperative spiral CT-assisted PBC.Results Postoperative pain was completely relieved in 25 cases(BNI grade Ⅰ),markedly improved in 3(grade Ⅱ),and partially relieved in 2(grade Ⅲ+Ⅳ).The effectiveness rate was 93.3%(28/30).The incidence of facial numbness was 93.3%(28/30),masseter muscle weakness 33.3%(10/30),tinnitus 3.3%(1/30),numbness and other uncomfortable symptoms were mostly improved or disappeared within 1 to 3 months,which did not affect quality of life,no serious surgical complications occurred.During the follow-up period,2 cases recurred,and the recent pain recurrence rate was 6.7%.Conclusions The PBC has a definite clinical effect in the treatment of TN,with less trauma and low risk,especially for patients with high risk,pain involving the first branch and recurrence.3D-CT guidance is used during the operation to ensure accurate positioning and reduce risks.
作者
伍犹梁
隋立森
谢学敏
余佳彬
张晓静
谢海涛
徐少群
肖建斌
陈春
Wu Youliang;Sui Lisen;Xie Xuemin;Yu Jiabin;Zhang Xiaojing;Xie Haitao;Xu Shaoqun;Xiao Jianbin;Chen Chun(Epilepsy Center,the Second Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510120,China;Department of Anesthesiology,the Second Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510120,China;Department of Encephalopathy,the Second Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510120,China)
出处
《中国微侵袭神经外科杂志》
CAS
2020年第10期453-456,共4页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
三叉神经痛
经皮球囊压迫
螺旋CT
trigeminal neuralgia
percutaneous balloon compression
spiral CT
