DSA 机引导下射频热凝术治疗老年原发性三叉神经痛的临床分析

摘要

Objective To explore the clinical effect and safety of radiofrequency thermocoagulation guided by DSA for elderly patients with idiopathic trigeminal neuralgia(ITN). Methods 62 elderly patients with ITN were randomly divided into group A(n = 31)and group B(n= 31). Group A and group B were given radiofrequency thermocoagulation guided by DSA and gamma knife radiosurgery,respectively. The pain- free rate in different time,recurrence rate and complications between two groups were compared. Results The total pain - free rate at 1 week and 3 months after surgery in group A was significantly higher than that in group B( P ﹤ 0. 05),while there was no significant difference at 6 and 12 months after surgery( P ﹥ 0. 05). The recurrence rate at 12 months after surgery in group A was significantly lower than that in group B( P﹤ 0. 05). The main complications were facial hypoesthesia,local ecchymoma,weakness of jaws,restriction of mouth opening;while there was no significant difference in the incidence of complications between two groups( P ﹥ 0. 05). Conclusion Radiofrequency thermocoagulation guided by DSA for elderly patients with ITN has accurate localization,can increase pain - free rate and reduce recurrence.%目的：探讨数字血管减影机（DSA）引导下射频热凝术治疗老年原发性三叉神经痛（ ITN）的疗效及安全性。方法将62例老年 ITN 患者随机分为 A、B 两组，各31例。A 组采用 DSA 机引导下射频热凝术治疗，B 组采用伽玛刀治疗。比较两组不同时间点（术后1周，3、6、12个月）的缓解率、复发率及并发症发生情况。结果 A 组术后1周、3个月累计缓解率显著高于 B 组（ P ﹤0.05），而两组术后6个月、12个月比较，差异均无统计学意义（ P ﹥0.05）；A 组术后12个月复发率显著低于 B 组（ P ﹤0.05）。两组并发症主要为面部感觉减退或麻木、局部皮下血肿、咬颌无力、张口受限，两组并发症发生率比较，差异均无统计学意义（ P ﹥0.05）。结论 DSA 引导下射频热凝术治疗老年 ITN 患者，定位准确，可提高疼痛缓解率，减少复发。