摘要
目的比较治疗原发性三叉神经痛三种不同方法的临床疗效。方法自2000年5月至2004年6月收治的原发性三叉神经痛患者232例,其中80例行微血管减压术,77例行伽玛刀放射治疗,75例行三叉神经半月节后根甘油阻滞术。术后随访5年以上,对比分析治疗后的即刻缓解率、5年有效率及复发率。结果微血管减压组、伽玛刀治疗组和甘油阻滞组治疗后即刻缓解率分别为81.25%(65/80)、15.58%(12/77)和77.33%(58/75),甘油阻滞组与微血管减压组术后即刻缓解率均显著高于伽玛刀治疗组(P<0.05);5年有效率分别为91.25%(73/80)、63.64%(49/77)和16.00%(12/75),微血管减压组明显高于伽玛刀治疗组及甘油阻滞组(P<0.05),而伽马刀治疗组又高于甘油阻滞组(P<0.05);复发率分别为8.75%(7/80)、20.77%(16/77)和32.00%(24/75),甘油阻滞组复发率最高,其次为伽玛刀组,微血管减压组最低,三组之间差异显著(P<0.05)。结论微血管减压术是治疗原发性三叉神经痛的最佳方法;伽马刀和甘油阻滞术适合于老年患者或有手术禁忌症者,但采用伽玛刀治疗多数患者不能达到疼痛立即缓解,而甘油阻滞术早期效果好,但复发率高。
Objective To explore the therapeutic effects of different operative procedures on the primary trigeminal neuralgia and their operative indications. Methods Of 232 patients with primary trigeminal neuralgia,80 underwent microvascular decompression,77 gamma knife and 75 percutaneous retrogasserian neurolysis with glycerol. The immediate remission rate after the operation,the five– year remission rate and the relapse rate were observed and statistically analyzed in all the group. Results The immediate remission rates were 81.25%（65/80） ,15.84%（12/77） and 77.33%（58/75） ,the five-year remission rates were 91.25%（73/80） ,63.63%（48/77） and 16.00%（12/75） ,and the five-year relapse rates were 8.75%（7/80） ,20.77%（16/77） and 32.00%（24/75） respectively in the microvascular decompression,gamma knife treatment and percutaneous retrogasserian neurolysis with glycerol groups. The five-year remission rate was significantly higher and the five-year relapse rate was significantly lower in the microvascular decompression group than those in gamma knife treatment and percutaneous retrogasserian neurolysis with glycerol groups（P0.05） . The immediate remission rate was significantly higher in the microvascular decompression and percutaneous retrogasserian neurolysis with glycerol groups than that in gamma knife treatment group（P0.05） . The five-year remission rate was significantly higher in gamma knife treatment group than that in the retrogasserian neurolysis with glycerol group（P0.01） . Conclusion The therapeutic effect of microvascular decompression on the primary trigeminal neuralgia is significantly better than those of gamma knife treatment and percutaneous retrogasserian neurolysis with glycerol.
出处
《中国临床神经外科杂志》
2011年第3期153-155,共3页
Chinese Journal of Clinical Neurosurgery
关键词
原发性三叉神经痛
微血管减压
伽玛刀
半月节后根阻滞
疗效
Primary trigeminal neuralgia
Microvascular decompression
Gamma knife
Percutaneous retrogasserian neurolysis
Glycerol
Curative effect
