【摘要】 目的观察CT引导下经皮卵圆孔穿刺,半月神经节注射乙醇或阿霉素毁损治疗三叉神经痛的效应。方法92例原发性三叉神经痛患者,男39例,女53例,年龄37-84岁,病程1-14年,随机分为2组。治疗前CT冠状及轴位扫描卵圆孔和颅后窝,除外继发性三叉神经痛。在穿刺卵圆孔过程中CT引导穿刺的方向并确认针尖的位置,经造影确保穿刺针准确位于神经节内,A组向三叉神经半月节注射神经破坏药乙醇,B组注射阿霉素。结果治疗后12个月,两组分别有31例和36例完全无痛,13例和6例未缓解,组间比较差异有统计学意义(P<0.05),两组均无严重并发症。结论CT引导下经皮半月神经节毁损术治疗三叉神经痛效果明显,阿霉素的疗效优于乙醇。更多还原

【Abstract】 Objective Percutaneous puncture of gasserian ganglion was guided by CT scan to improve the accuracy and reduce complications and to compare the efficacy of chemical mutilation with ethyl alcohol and adriamycin.Methods Ninety-two patients with primary trigeminal neuralgia (39 males, 53 females) aged 37-84 yrs were divided into two groups : A ethyl alcohol group ( n = 47) and B adriamycin group ( n = 45) . Secondary trigeminal neuralgia was excluded by preoperative CT scan. Percutaneous puncture of oval foramen was guided by CT and correct location of needle tip was confirmed by injection of contrast medium. 100% ethyl alcohol 0.5ml (group A) or 2% adriamycin 0.5ml was injected.Results The patients were followed up for 12 months after treatment. Neuralgia disappeared in 31 out of 47 patients in group A (alcohol group) and in 36 out of 45 patients in group B (adriomycin group) . Treatment failed in 13 patients in group A and 6 patients in group B, and was partly effective in the other patients. There were no severe side effects or complications. Conclusion Percutaneous puncture of gasserian ganglion guided by CT is effective and reduces complications. Adriamycin is more effective than ethyl alcohol for chemical mutilation.更多还原