摘要
目的:探讨三叉神经痛半月节及外周支射频控温热凝的疗效。方法:半月节采用Hartel前路法进行穿刺经卵圆孔,进针方向、矢状面上针尖对准耳前点,冠状面上针尖对准同侧瞳孔中央。外周支:第Ⅰ支穿刺眶上切迹或眶上孔,射频控温热凝眶上神经或滑车上神经;第Ⅱ支穿刺圆孔或眶下孔,也可圆孔加眶下孔,射频控温热凝上颌神经或眶下神经;第Ⅲ支穿刺卵圆孔或颏孔,也可卵圆孔加颏孔,射频控温热凝下颌神经或颏神经。结果:本组208例,破坏了痛觉而保留了触觉。半月节射频控温热凝160例,一次射频治疗完全止痛151例(94.3%),1周后行二次射频完全止痛9例(5.7%)。外周支射频控温热凝48例,一次射频治疗后均完全止痛。结论:应用射频控温热凝半月节及外周支治疗三叉神经痛,能保留触觉仅破坏痛觉,治疗止痛效果确切,相对安全,适应症广,操作较简便,可重复多次施术且止痛效果同样很好。
Objective： To investigate the effects of percutaneous radiofrequency ablation of semilunar ganglion and its peripheral branches on trigeminal neuralgia. Methods：Semilunar ganglion was by Hartel＇s anterior path to puncture through foramen ovale. Peripheral branches were through supraorbital foramen to ablate supraorbital nerve, through foramen rotundum and/or infraorbital foramen to ablate infraorbital nerve, and through foramen ovale and/or mental foramen to ablate mandibular nerve. Results： Of the 208 cases, the fibers of sense of pain were damaged while those of sense of touch remained. Of 160 cases ablated through Gasser＇s ganglion, pain in 151 cases was completely controlled by the first ablation , pain in 9 cases was completely controlled after one week by the second ablation. Pain in 48 cases ablated through peripheral branches was completely controlled by the first ablation. Conclusion： Radiofrequency thermal ablation of semilunar ganglion and its peripheral branches for the treatment of trigeminal neuralgia only damages the sense of pain and remains the sense of touch, has reliable effect on pain, is easily manipulated and comparatively safe, can be repeated several times.
出处
《泸州医学院学报》
2009年第3期288-291,共4页
Journal of Luzhou Medical College
关键词
半月节
外周支
射频
三叉神经痛
Semilunar ganglion
Peripheral branches
Radiofrequency thermal ablation
Trigeminal neuralgia
