| 摘要: |
| 目的对比微血管减压术（MVD）联合电凝术与单纯MVD治疗原发性三叉神经痛（TN）的临床疗效。方法将326例原发性TN患者按手术方案分为两组，MVD联合电凝术治疗131例（MVD+电凝组），单纯MVD治疗195例（MVD组），分析比较两组患者术后疗效、并发症等情况。结果MVD+电凝组和MVD组手术有效率分别为96.2%和92.3%，两组比较差异无统计学意义（P＞0.05）；术中血管压迫无法充分减压及无明确责任血管的患者手术有效率MVD+电凝组高于MVD组（95.2%vs67.7%,P＜0.05）；MVD+电凝组术后近期（≤6个月）术侧面部麻木发生率高于MVD组（21.4%vs7.7%,P＜0.05），远期（＞6个月）术侧面部麻木发生率两组比较无统计学差异（4.6%vs2.6%,P＞0.05）。结论MVD联合电凝术和单纯MVD均能有效治疗原发性TN，相较于单纯MVD，MVD联合电凝术可以改善术中血管压迫无法充分减压及无明确责任血管的原发性TN患者的术后疗效，不会增加患者远期术侧面部麻木发生率。 |
| 关键词: 三叉神经痛 微血管减压术 电凝术 |
| DOI： |
| 分类号: |
| 基金项目:浙江省医药卫生科技计划项目 |
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| Treatment of primary trigeminal neuralgia: microvascular decompression versus microvascular decompression combined with electrocoagulation |
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DU Quan, YU Wenhua, HU Qiang
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Hangzhou First People's Hospital
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| Abstract: |
| Objective To compare therapeutic effect of microvascular decompression (MVD) and MVD combined with
elctrocoagulation for patients with primary trigeminal neuralgia. Methods Three hundred and twenty six patients with primary trigeminal neuralgia were divided into two groups according to the surgical plan, 195 cases received microvascular decompression therapy alone (MVD group) and 131 cases received microvascular decompression combined with electrocoagulation treatment (MVD+coagulation group). The therapeutic efficacy, complications, and disease recurrence were analyzed and compared between
two groups. Results There were no significant differences in overall effective rate (96.2% vs. 92.3%) between two groups (P ＞0.05).
However, the effective rate in MVD+coagulation group was higher than that in MVD group for patients with not sufficient vascular decompression during surgery or no vascular compression (95.2% vs. 67.7%, P＜0.05). The short-term incidence of facial paralysis or facial numbness was significantly higher in MVD+coagulation group than that in MVD group after treatment (21.4 % vs. 7.7%, P＜ 0.05). There was no significant difference in long-term incidence of facial numbness between two groups (4.6 % vs. 2.6%, P ＞0.05). Conclusion MVD+coagulation and MVD both are effective in treatment of primary trigeminal neuralgia. However, MVD+coagulation may be better option for primary trigeminal neuralgia patients with no sufficient vascular decompression or no clear vascular compression without increase the long-term incidence of facial numbness. |
| Key words: Trigeminal neuralgia Microvascular decompression Coagulation |
