C臂引导下射频热凝治疗三叉神经痛的回顾性分析

摘要

Objective: To evaluate the long-term efficacy of percutaneous radiofrequency thermocoagulation for trigeminal neuralgia. Methods: The patients with trigeminal neuralgia admitted to Department of Pain Management of Shandong Provincial Hospital from June 2009 to July 2014 and accepted radiofrequency thermocoagulation were retrospectively analyzed. The baseline characteristics, immediate outcome, pain-free duration and complications of the patients were obtained by the return visit and follow-up. The effects of gender, age, affected side, affected branch, and the temperature of radiofrequency thermocoagulation on the long-term pain-free rate and the recurrence differ-ence were assessed by Kaplan-Meier analysis and chi-square test. Results: Kaplan-Meier analysis showed no signifi-cant differences in the gender, age, affected side and the temperature of radiofrequency thermocoagulation (P > 0.05). However, the long-term outcome of isolated 3rd-division trigeminal neuralgia patients (V3 TN) was significantly better than that of isolated 2nd-division (V2 TN) and both 2nd- and 3rd-division trigeminal neuralgia patients (V2+V3 TN) (P < 0.05). There was no significant difference between V2 TN and V2+V3 TN (P > 0.05). Conclusions: Gen-der, age, affected side and the temperature of the radiofrequency thermocoagulation have not showed the statistical ef-fect on the long-term outcome of radiofrequency thermocoagulation for trigeminal neuralgia; the long-term outcome of radiofrequency thermocoagulation for V3 TN is better than V2 TN or V2+V3 TN.%目的:回顾性分析半月神经节射频热凝治疗三叉神经痛的临床疗效及其影响因素.方法:选取2009年6月至2014年7月就诊于我科接受半月神经节射频热凝的三叉神经痛病人.通过Kaplan-Meier分析和Log-rank检验比较不同性别、年龄、侧别、神经分支及射频温度对病人的复发情况及长期无痛率的影响.结果:不同性别、年龄、侧别及射频温度对于病人复发情况及长期无痛率影响的差异无统计学意义(P > 0.05).单纯Ⅲ支痛者的长期疗效显著优于单纯Ⅱ支或合并Ⅱ、Ⅲ支痛者(P < 0.05),单纯Ⅱ支与合并Ⅱ、Ⅲ支痛者之间差异无统计学意义(P > 0.05).结论:年龄、性别、侧别及射频温度均不是影响射频热凝治疗三叉神经痛长期疗效的因素;射频热凝治疗三叉神经单纯Ⅲ支痛者的长期疗效较单纯Ⅱ支或含有Ⅱ支多支病变的病人好.