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三叉神经痛的伽玛刀治疗

Gamma knife radiosurgery for the treatment of trigeminal neuralgia.

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【作者】 郑立高张志远徐德生张丽茵张宜培李彦和

【Author】 Zheng Ligao, Xu Desheng, Zhang Liyin, Zhang Zhiyuan, Zhang Yipei and Li Yanhe. Department of Neurosurgery and Gamma Knife Center, Second Hospital of Tianjin Medical University, 23 Pingjiang Road, Tianjin, 300211. Tel:022 28317828

【机构】 天津医科大学第二医院伽玛刀中心!300211

【摘要】 目的 探讨伽玛刀治疗三叉神经痛(TN) 的方法和疗效。方法 采用1-5 T MR 影像、GammaPlan 定位和治疗计划,Leksell 伽玛刀(γ刀) 治疗75 例TN,其中65 例非肿瘤性TN,治疗靶点在三叉神经感觉根入桥脑区,单个4 mm 准直器,中心剂量70~90 Gy,50 % 等剂量线限定靶点;10 例颅底肿瘤性三叉神经痛以肿瘤为照射靶区,中心剂量20 ~30 Gy,周边剂量10 ~15 Gy。结果 随访3 ~38 个月,全组疗效优者占57-3% ,良占30-7 % ,有效占5-3% ,总有效率93-3% ,非肿瘤性TN总有效率92-3 % 。4 例于5 ~17 个月疼痛复发。全组病人无任何并发症,无死亡。结论 伽玛刀是治疗三叉神经痛安全和有效的治疗方法。

【Abstract】 Objective To investigate the effectiveness of Gamma knife radiosurgery for the treatment of trigeminal neuralgia. Methods Target localization and dose plan were done by stereotactic MR(1.5 Tesla) study and Leksell Gamma Plan. Single 4 mm collimator with central dose 70 to 90 Gy and 50% isodose line conforming were directed at the sensory root of trigeminal nerve entry zone of pones for 65 patients with non tumor related trigeminal neuralgia, and for 10 patients with tumor related trigeminal neuralgia. The marginal dose used ranged from 10 to 15 Gy. Results The follow up period ranged form 3 to 38 months. Excellent result were obtained in 57 3%, good result in 30 7%, and moderate results in 5.3%, The total response rate was 93.3% and the overall response rate for non tumor related trigeminal neuralgia was 92.3%. Four patients experienced recurrent pain after 5 to 17 months. Neither complication nor motality was found during follow up. Conclusions Gamma knife radiosurgery is an effective and safe method for the treatment of trigeminal neuralgia.

【关键词】 三叉神经痛伽玛刀治疗
【Key words】 Trigeminal neuralgia Gamma knife Treament
  • 【文献出处】 中国神经精神疾病杂志 ,CHINESE JOURNAL OF NERVOUS AND MENTAL DISEASES , 编辑部邮箱 ,1999年06期
  • 【分类号】R745.11
  • 【被引频次】11
  • 【下载频次】55
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