【摘要】 目的研究伽玛刀与射频温控热凝技术治疗三叉神经痛的疗效差异。方法回顾性分析131例三叉神经痛病人的治疗效果,其中伽玛刀治疗47例(伽玛刀组),射频温控热凝治疗84例(射频组)。采用视觉模拟评分法(VAS评分)对术前、术后病人的三叉神经疼痛程度进行评分。术前伽玛刀组和射频组平均VAS评分分别为7.89和7.95,差异无统计学意义(P>0.05)。结果射频组术后即刻VAS评分0～1分,平均0.61分。伽玛刀组起效时间1周～14个月,平均6个月;VAS评分0～3分,平均1.0分。两组术后VAS评分差异无统计学意义(P>0.05)。伽玛刀组术后并发面部麻木6例;射频组并发面部麻木19例,咬肌瘫痪8例,复视1例和后组脑神经损伤1例;两组并发症发生率差异有统计学意义(P<0.05)。术后随访2个月～3年,射频组3例和伽玛刀组1例有不同程度的疼痛复发。结论伽玛刀和射频热凝治疗三叉神经痛均能取得肯定疗效,但伽玛刀治疗并发症较少且轻,相对更安全;其缺点是起效较慢。更多还原

【Abstract】 Objective To compare the treatment effects between Gamma knife radiosurgery (GKS) and radiofrequency thermocoagulation (RF) for trigeminal neuralgia (TN). Methods The treatment outcomes of 131 patients with TN were analyzed retrospectively, 47 out of them underwent GKS treatment and 84 underwent RF treatment. The visual analog scale (VAS) was used to assess the pain severity preoperatively and postoperatively. The average preoperative pain scores in GKS group and RF group were 7.89 and 7.95 respectively, no significant difference was found between the two groups (P > 0.05). Results The postoperative pain score immediately dropped to 0-1 in RF group, the average score was 0.61. However, the pain scores gradually dropped to 0-3 scores in GKS group, the average score was 1.0 and the average taking effect time was 6 months (ranged from 1 week to 14 months). No significant difference in postoperative VAS score was found between the two groups (P > 0.05). Facial numbness occurred in 6 patients in GKS group and in 19 in RF group. In addition, masseter muscle dysfunction was seen in 8 patients, diplopia in 1 patient and posterior cranial nerve injury in 1 in RF group. A significant difference in complication rate was found between the two groups (P < 0.05). During a follow-up period ranged from 2 months to 3 years, pain recurrence was found in 3 patients in RF group and in 1 in GKS group. Conclusions Both the treatment of GSK and RF can obviously relieve the pain in TN patients. Compared with RF, GKS has much less and slighter complications, so that it is safer, but it takes effect slower.更多还原