【作者】 伍犹梁； 隋立森； 谢学敏； 余佳彬； 张晓静； 谢海涛； 徐少群； 陈春；

【Author】 Wu Youliang;Sui Lisen;Xie Xuemin;Epilepsy center,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine;Department of Anesthesiology,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine;Encephalopathy functional Section,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine;

【机构】 广州中医药大学第二附属医院癫痫中心； 广州中医药大学第二附属医院麻醉科； 广州中医药大学第二附属医院脑病功能科；

【摘要】 目的探讨术中螺旋CT三维重建辅助下卵圆孔定位的优势,总结经皮穿刺三叉神经半月节球囊压迫术(PBC)治疗顽固性三叉神经痛(TN)的安全性及疗效。方法回顾性分析我院2018年12月至2019年12月采用术中螺旋CT引导下PBC治疗的30例顽固性TN患者的临床资料,分析、总结术后疗效及并发症。结果术后疼痛完全缓解25例,疼痛明显好转3例,部分好转2例,有效率为93.3%(28/30)。患侧面部麻木发生率93.3%(28/30),咀嚼乏力33.3%(10/30),耳鸣3.3%(1/30),麻木等不适症状多在1-3个月内明显好转或消失,不影响生活,无严重手术并发症发生。随访期内复发2例,近期疼痛复发率约为6.7%。结论PBC治疗TN近期临床效果确切,创伤小,风险低,尤其对于高危、疼痛累及第I支、及其他手段治疗后复发的患者更有优势。术中采用3D-CT引导,定位准确,降低风险。更多还原

【Abstract】 Objective To investigate the advantages of puncture foramen ovale,and the effectivenessof percutaneous balloon compression of Gasserian ganglion(PBC) for refractory trigeminal neuralgia(TN) under the assistance of spiral CT and three-dimensional reconstruction technique.Methods Retrospective analysis of clinical data of 30 patients with refractory TN treated with PBC,investigatedthe efficacy and postoperative complications of spiral CT-assisted PBC.Results After PBC,pain relief was immediate in 25 patients,and 3 patient had some pain and need no medication,2 patients were partial relief,The total effectiveness was 93.3%(28/30).facial numbness was93.3%(28/30),masseter muscle weaknes was33.3%(10/30),tinnitus was 3.3%(1/30).Postoperative morbidity included common side effects such as facial numbness would be obviously improve or disappear on 1-3 months later,which didn’t affect quality of life.No corneal anesthesia、subarachnoid hemorrhage or other seriouscomplications occurted in this study.2 cases(6.7%)were recurrence with a follow-up after PBC.Conclusion Spiral CT-assisted PBC is an effective,minimally invasive and safe method for refractory TN patients,Especially with high risk,pain involving the first branch,and recurrence after treatment with other method.Spiral CT-assisted can improve accuracy and reduce risk during the PBC.更多还原