[1]罗　波 范润金 张　逵 尚　彬 刘　毅 唐晓平.全程围套式微血管减压术治疗原发性三叉神经痛的临床分析[J].中国临床神经外科杂志,2017,(10):687-689692.[doi:10.13792017.09/j.issn.1009-153X.2017.10.005]
　LUO Bo,FAN Rui-jin,ZHANG Kui,et al.Clinical analysis of the treatment of primary trigeminal neuralgia by whole-range encircling method of microvascular decompression[J].,2017,(10):687-689692.[doi:10.13792017.09/j.issn.1009-153X.2017.10.005]
点击复制

全程围套式微血管减压术治疗原发性三叉神经痛的临床分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年10期
页码:
687-689692
栏目:
论著
出版日期:
2017-10-25

文章信息/Info

Title:
Clinical analysis of the treatment of primary trigeminal neuralgia by whole-range encircling method of microvascular decompression
文章编号:
1009-153X（2017）10-0687-03
作者:
罗　波 范润金 张　逵 尚　彬 刘　毅 唐晓平
710000 西安，第四军医大学唐都医院神经外科
Author(s):
LUO Bo1;  FAN Rui-jin1;  ZHANG Kui1;  SHANG Bin1;  LIU Yi1;  TANG Xiao-ping2.
1. Department of Neurosurgery, Nanchong Central Hospital, the Second Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China; 2. Department of Neurosurgery, Affiliated Hospital, North Sichuan Medical College, Nanchong 637000, China
关键词:
原发性三叉神经痛; 微血管减压术; 全程围套式减压术; 疗效
Keywords:
Primary trigeminal neuralgia;  Microvascular decompression;  A whole-range encircling method;  Curative effect
分类号:
R 745.1+1; R 651.1+1
DOI:
10.13792017.09/j.issn.1009-153X.2017.10.005
文献标志码:
A
摘要:
目的 探讨全程围套式微血管减压术治疗原发性三叉神经痛的方法和疗效。方法 回顾性分析2012年1月至2016年10月采用微血管减压术治疗的126例原发性三叉神经痛的临床资料，全程围套式减压69例（观察组），常规减压57例（对照组）。所有病人门诊或电话随访6个月~2年。结果 术中发现责任血管压迫或接触三叉神经115例，未发现责任血管11例。观察组疗效优58例，良7例，中3例，差1例；对照组疗效优40例，良6例，中7例，差4例；观察组疗效明显优于对照组（P<0.05）。观察组复发率（3.45%，2/58）明显低于对照组（17.50%，7/40；P<0.05）。两组术后并发症总发生率无统计学差异（P>0.05）。结论 全程围套式微血管减压术可充分减压三叉神经，也可防止减压材料移位，在不增加并发症的情况下降低复发率，是治疗原发性三叉神经痛安全、有效的手术方式。
Abstract:
Objective To discuss the technique of whole-range encircling method of microvascular decompression (MVD) for primary trigeminal neuralgia (PTN) and its effect. Methods The clinical data of 126 patients with PTN treated by microvascular decompression were analyzed retrospectively. Of 126 patients with PTN, 69 (observed group) were treated by MVD whole-range encircling method and 57 (control group) by conventional MVD. The treatment effects and rates of complications occurrence and PTN recurrence were compared between the two groups. All patients were followed from 6 months to 2 years. Results The blood vessels responsible for PTN were found in 115 patients, and 11 not. The effective rate (98.55%) was significantly higher in the observed group than that (92.98%) in the control group (P<0.05). PTN recurrence rate (3.45%) was significantly lower in the observed group than that (17.50%) in the control group (P<0.05). There was no significant difference in the rates of complications occurrence between both the group (P>0.05). Conclusions The whole-range encircling method of MVD is a safe and effective method to treat PTN, because it can fully decompress trigeminal never, prevent the decompression material from sliding and reduce PTN recurrence rate without increasing complications.

参考文献/References:

[1] Broggi G, Ferroli P, Franzini A, et al. Operative findings andoutcomes of microvascular decompression for trigeminal neuralgia in 35 patients affected by multiple sclerosis [J]. Neurosurgery, 2004, 55: 830-838.
[2] 秦泗佳，王　福. 原发性三叉神经痛发病机制的研究进展[J]. 中华神经外科杂志，2012，28（12）：1293-1295.
[3] Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia [J]. J Neuro-surg, 1967, 26(1): 159-162.
[4] 马　凯，李勇杰，胡永生，等. 三叉神经痛显微血管减压术中岩静脉处理策略的研究[J]. 中华神经外科杂志，2015，31（1）：44-47.
[5] Chakravarthi PS, Ghanta R, Kattimani V. Microvascular decompression treatment for trigeminal neuralgia [J]. J Craniofac Surg, 2011, 22(3): 894-898.
[6] 程志华，郭智霖. 三叉神经痛微血管减压手术无效的原因分析[J]. 立体定向和功能性神经外科杂志，2007，20（4）：229-230.
[7] 种衍军，陈　剑，王召平，等. 三叉神经痛显微血管减压术后长期疗效及复发因素分析[J]. 中华神经外科杂志，2011，27（5）：449-453.
[8] Cho DY, Chang CG, Wang YC, et al. Repeat operations in failed microvascular decompression for trigeminal neuralgia[J]. Neurosurgery, 1994, 35(4): 665-670.
[9] Matsushima T, Yamaguchi T, Inoue TK, et al. Recurrent trigeminal neuralgia after microvascular decompression using an interposing technique: teflon felt adhesion and the sling retraction technique [J]. Acta Neurochir (Wien), 2000,142(5): 557-561.
[10] 郑　鲁，陈援朝，吕福林，等. 围套式显微血管减压术治疗三叉神经痛912例[J]. 中国疼痛医学杂志，2002，8（3）：134-137.
[11] 漆松涛，袁智锐，潘　军，等. 显微完全血管减压术的疗效分析及手术技术改进[J]. 中国微侵袭神经外科杂志，2007，12（8）：362.
[12] Capelle HH, Brandis A, Tschan CA, et al. Treatment of recurrent trigeminal neuralgia due to Teflon granuloma [J]. J Headache Pain, 2010, 11(4): 339-344.
[13] 刘　鹏，黄胜平，漆松涛，等. 生物型人工硬脑膜应用的实验研究[J]. 第一军医大学学报，2004，24（11）：1242-1244.

相似文献/References:

[1]杜　浩　黄　河　宋　健　何远志　孙荣辉　丁慧超　姚　顺　徐国政.面肌痉挛微血管减压术后并发症的相关危险因素分析[J].中国临床神经外科杂志,2016,(05):267.[doi:10.13798/j.issn.1009-153X.2016.05.004]
　DU Hao,HUANG He,SONG Jian,et al.Analysis of risk factors related to complications after microvascular decompression in patients with hemifacial spasm[J].,2016,(10):267.[doi:10.13798/j.issn.1009-153X.2016.05.004]
[2]申彦杰　宋　健　成文平　程东亮.微血管减压术治疗面肌痉挛57例[J].中国临床神经外科杂志,2016,(04):238.[doi:10.13798/j.issn.1009-153X.2016.04.016]
[3]黄　进　吴祥奎　张岩松　邵君飞.肌电图监测在面肌痉挛微血管减压术中的应用[J].中国临床神经外科杂志,2016,(03):164.[doi:10.13798/j.issn.1009-153X.2016.03.011]
　HUANG Jin,WU Xiang-kui,ZHANG Yan-song,et al.Application of EMG monitoring to microvascular decompression for hemifacial spasm[J].,2016,(10):164.[doi:10.13798/j.issn.1009-153X.2016.03.011]
[4]曾　冉　王飞红　袁邦清　杨　光　苏同刚.微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2016,(03):175.[doi:10.13798/j.issn.1009-153X.2016.03.016]
[5]蒋　伟　孙守家　高　攀　张晓静　舒　凯　雷　霆　李　龄.异常椎基底动脉压迫致三叉神经痛的临床特点及显微手术治疗（附16例分析）[J].中国临床神经外科杂志,2016,(02):69.[doi:10.13798/j.issn.1009-153X.2016.02.002]
　JIANG Wei,SUN Shou-jia,GAO Pan,et al.Clinical features and microsurgical treatment of trigeminal neuralgia caused by abnormal vertebrobasilar artery compression (report of 16 cases)[J].,2016,(10):69.[doi:10.13798/j.issn.1009-153X.2016.02.002]
[6]宋　健　刘　敏　丁慧超　杜　浩　向伟楚　黄　成　黄　河　孙荣辉　何远志　徐国政　马廉亭.术前MRI与Dyna-CTA三维影像融合对微血管减压术难易程度的评估价值[J].中国临床神经外科杂志,2015,(10):597.[doi:10.13798/j.issn.1009-153X.2015.10.007]
　SONG Jian,LIU Min,DING Hui-chao,et al.Value of preoperative MRI and Dyna-CTA 3D-imaging fusion to microvascular decompression[J].,2015,(10):597.[doi:10.13798/j.issn.1009-153X.2015.10.007]
[7]向兴刚　张永辉　李大志　昝向阳　于晓晨　蔡　宁　赵　永　林　琳.神经内镜辅助微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2015,(10):624.[doi:10.13798/j.issn.1009-153X.2015.10.015]
[8]吴广源　尹　卫　郑思阳　齐　辉.自体颅骨碎屑一期修复颅神经微血管减压术骨窗的临床观察[J].中国临床神经外科杂志,2015,(06):364.[doi:10.13798/j.issn.1009-153X.2015.06.016]
[9]卫永旭　杨文磊　赵卫国　李　宁　蔡　瑜　濮春华　吴哲褒.肌松药对面肌痉挛微血管减压术中电生理监测的影响[J].中国临床神经外科杂志,2015,(09):526.[doi:10.13798/j.issn.1009-153X.2015.09.005]
　WEI Yong-xu,YANG Wen-lei,ZHAO Wei-guo,et al.Effect of muscle relaxants on lateral spread responses during microvascular decompression for hemifacial spasm[J].,2015,(10):526.[doi:10.13798/j.issn.1009-153X.2015.09.005]
[10]耿　飞.枕下乙状窦后入路微血管减压治疗面肌痉挛的并发症及处理[J].中国临床神经外科杂志,2015,(03):168.[doi:10.13798/j.issn.1009-153X.2015.03.014]
[11]荣道建　何　颖　杨晓健　赵　骞　赵俊伟　杨　峰.三维时间飞跃法磁共振血管成像在原发性三叉神经痛诊治中的临床价值[J].中国临床神经外科杂志,2015,(04):241.[doi:10.13798/j.issn.1009-153X.2015.04.018]
[12]何少宇,李　玉,李　杨,等.原发性三叉神经痛微血管减压术中岩静脉的处理[J].中国临床神经外科杂志,2016,(12):747.[doi:10.13798/j.issn.1009-153X.2016.12.005]
　HE Shao-yu,LI Yu,LI Yang,et al.Management of petrosal vein in microvascular decompression for primary trigeminal neuralgia[J].,2016,(10):747.[doi:10.13798/j.issn.1009-153X.2016.12.005]
[13]耿亮,王义宝,王占福.微血管减压术治疗原发性三叉神经痛126例[J].中国临床神经外科杂志,2017,(02):95.[doi:10.13798/j.issn.1009-153X.2017.02.011]
[14]郑　玺.微血管减压术治疗原发性三叉神经痛65例[J].中国临床神经外科杂志,2018,(06):429.[doi:10.13798/j.issn.1009-153X.2018.06.016]
[15]侯前亮.“补片悬吊法”微血管减压术治疗原发性三叉神经痛 的疗效观察[J].中国临床神经外科杂志,2018,(12):810.[doi:10.13798/j.issn.1009-153X.2018.12.017]
[16]王　飞　张　挺　廖毓芝　袁　磊　王兆伟　张保中.不同类型原发性三叉神经痛的手术疗效分析[J].中国临床神经外科杂志,2019,(01):10.[doi:10.13798/j.issn.1009-153X.2019.01.002]
　WANG Fei,ZHANG Ting,LIAO Yu-zhi,et al.Analysis of curative effect of surgery on primary trigeminal neuralgia[J].,2019,(10):10.[doi:10.13798/j.issn.1009-153X.2019.01.002]
[17]张文斗,范　波,胡会敏,等.原发性三叉神经痛微血管减压术后复发的影响因素分析[J].中国临床神经外科杂志,2019,(04):221.[doi:10.13798/j.issn.1009-153X.2019.04.010]
　ZHANG Wen-dou,FAN Bo,HU Hui-min,et al.Factors related to recurrence of primary trigeminal neuralgia after microvascular decompression[J].,2019,(10):221.[doi:10.13798/j.issn.1009-153X.2019.04.010]
[18]孙红山　赵帅杰　王昊天　闵有会.显微血管减压术联合三叉神经感觉根部分切断术治疗伴静脉压迫的原发性三叉神经痛[J].中国临床神经外科杂志,2019,(08):498.[doi:10.13798/j.issn.1009-153X.2019.08.017]
[19]逯德胜　陈　亮　逯莞婷　展群岭.神经内镜下和显微镜下微血管减压术治疗原发性三叉神经痛疗效的meta分析[J].中国临床神经外科杂志,2019,(10):602.[doi:10.13798/j.issn.1009-153X.2019.09.004]
　LU De-sheng,CHEN Liang,LU Wan-ting,et al.Meta-analysis of neuroendoscopic microvascular decompression for idiopathic trigeminal neuralgia[J].,2019,(10):602.[doi:10.13798/j.issn.1009-153X.2019.09.004]
[20]秦　瑜　和华元　马　建　陈　祎.原发性三叉神经痛微血管减压术后面部麻木的危险因素分析[J].中国临床神经外科杂志,2020,(11):783.[doi:doi:10.13798/j.issn.1009-153X.2020.11.017]

备注/Memo

备注/Memo:
作者单位：710000 西安，第四军医大学唐都医院神经外科（邬迎喜、赵天智、赵兰夫、吕文海、王　元、薛亚飞、贺世明）通讯作者：贺世明，E-mail：hshimin@fmmu.edu.cn
更新日期/Last Update: 1900-01-01