【摘要】 目的探讨微血管减压术(MVD)与球囊压迫术(PBC)治疗三叉神经痛(TN)的疗效。方法选取140例TN患者随机分为MVD组和PBC组各70例。对比2组术后疼痛缓解情况、术后并发症以及复发情况,分析治疗前后2组血清去甲肾上腺素(NE)、皮质醇(Cor)和髓过氧化物酶(MPO)水平差异。结果 PBC组中平均手术时间、住院时间和住院费用均低于MVD组(P<0.05)。PBC组术后即刻疼痛缓解情况明显优于MVD组(P<0.05),而2组术后3个月、术后1 a疼痛缓解情况及术后1 a复发率比较,差异无统计学意义(P>0.05)。PBC组术后面部麻木、咀嚼无力的发生率显著高于MVD组(P<0.05);术后6 h,PBC组患者血清NE、Cor、MPO水平均低于MVD组(P<0.05)。结论 MVD和PMC术治疗TN的远期疗效均较好,且复发率低;MVD手术并发症发生率小于PMC,但PMC手术应激刺激低于MVD,临床上应根据患者情况选择合适术式。更多还原

【Abstract】 Objective To investigate the effect of microvascular decompression(MVD) and percutaneous balloon compression(PBC) in treatment of trigeminal neuralgia(TN).Methods The clinical data of 140 patients with TN were randomly divided into MVD group and PBC group,with 70 cases in each group.The postoperative pain relief,postoperative complications and recurrence of two groups were compared.The levels of noradrenaline(NE),cortisol(Cor) and myeloperoxidase(MPO) were compared between two groups before and after treatment.Results The average operation time,hospitalization time and hospitalization cost in PBC group were lower than MVD group(P<0.05).Immediate postoperative pain relief in PBC group was significantly better than MVD group(P<0.05).There was no significant difference in pain relief 3 months after surgery,1 year after surgery and recurrence rate 1 year after surgery between two groups(P>0.05).The incidence of postoperative facial numbness and masticatory weakness in PBC group was significantly higher than MVD group(P<0.05).6 h after surgery,the levels of NE,Cor and MPO in PBC group were lower than MVD group(P<0.05).Conclusion Both MVD and PMC have better long-term efficacy in the treatment of trigeminal neuralgia and the recurrence rate is low.The MVD in incidence of complications is lower than PMC,but the stress of PMC is lower than that of MVD.Therefore,appropriate surgical methods should be selected according to the patient’s condition.更多还原