三叉神经感觉根梳理术和半月节射频术治疗原发性三叉神经痛的临床疗效比较

摘要

Objective To compare clinical effectiveness of neurocombing (NC) and percutaneous radiofrequency thermocoagulation (RF) in the treatment of primary trigeminal neuralgia and evaluate its clinical significance.Methods Thirty seven patients with trigeminal neuralgia without neurovascular compression and undergoing neurocombing (NC group) and 37 trigeminal neuralgia patients obtaining percutaneous radiofrequency thermocoagulation (RF group) were given 3-year follow-up.Postoperative effectiveness rate,recurrence rate and occurrence rate of facial numbness were recorded and compared in the two groups of patients.Results In the NC group and RF group,postoperative 3-year effectiveness rate was 78.4％ (29/37) and 73.0％ (27/37) respectively.Postoperative 3-year recurrence rate was 21.6％ (8/37) and 27.0％ (10/37) respectively,as well as postoperative occurrence rate of facial numbness was 91.9％ (34/ 37) and 100％ (37/37).All intergroup differences were not statistically significant (P all ＞ 0.05).Conclusion NC and RF are both satisfactory treatment strategies for patients with primary trigeminal neuralgia.When taking into account the risk of craniotomy,RF is preferable to NC in some elderly patients with trigeminal neuralgia without neurovascular compression.%目的 比较三叉神经感觉根梳理术和半月节射频术治疗原发性三叉神经痛的临床效果,揭示其临床意义.方法 对37例没有明显血管压迫的且行颅内段三叉神经感觉根梳理术治疗的原发性三叉神经痛患者(梳理术组)和37例行三叉神经半月节射频术治疗的原发性三叉神经痛患者(射频术组)进行3年随访,记录和比较两组患者术后疼痛治疗有效率、复发率和颜面部麻木发生率.结果 梳理术组和射频术组术后3年有效率分别为78.4％ (29/37)和73.0％ (27/37),术后3年复发率分别是21.6％ (8/37)和27.0％ (10/37),术后颜面部麻木发生率分别为91.9％(34/37)和100％ (37/37),组间比较差异均无统计学意义(P均＞ 0.05).结论 三叉神经感觉根梳理术和半月节射频术是治疗原发性三叉神经痛较为理想的手段,考虑到开颅手术的风险,三叉神经半月节射频术可能更合适于治疗没有明显血管压迫的原发性三叉神经痛老年患者.