无水酒精注射治疗原发性三叉神经痛

Treatment of patients with primary trigeminal neuralgia by ethanol injection

目的探讨原发性三叉神经痛的发病机制、无水酒精注射治疗的疗效及复发因素。方法对运用无水酒精注射治疗原发性三叉神经痛245例的临床资料及治疗经过进行了观察和分析。结果245例原发性三叉神经痛患者经无水酒精注射治疗后,疼痛消失165例,疼痛减轻80例,近期总有效率100.00%。随访有44例复发,其中6￣12个月复发16例,1、2a复发21例。2a以上7例,总复发率为17.96%。结论原发性三叉神经痛的可能发病机制有中枢病因学说、周围病因学说、免疫、生化等因素;无水酒精注射治疗原发性三叉神经痛,创伤小,疗效肯定,复发率低;神经纤维的再生或神经远端功能并非完全丧失、神经孔数目的变异及交通支的存在等是无水酒精注射治疗原发性三叉神经痛的复发因素。

To explore the mechanism of primary trigeminal neuralgia (PTN), therapy of patients with PTN by ethanol injection and their recurrent factors. 245 patients with PTN were treated by ethanol injection and their clinical data and therapy were observed and analyzed. After 245 patients with PTN were treated by ethanol injection, pain of 165 patients disappeared and pain of 80 patients was alleviated. In the near future the effective rate was 100.00%. With visit between 6 months and one year 16 patients recured, with visit between one year and two years 21 patients recured, and with visit of more than two years 7 patients recured, and the total recurrent rate was 17.96%. [Conclusion] Patients with PTN are brought about by the possible factors such as pathological changes of centrical nerve, pathological changes of peripheral nerve, immunity, and biochemistry, and so on. Effect of treatment of patients with PTN by ethanol injection is certain, hurt is slight and the recurrent rate is low. The recurrence of patients with PTN which are treated by ethanol injection is brought about by the possible factors such as regeneration of nerve fiber, incomplete loss of function of the far end of nerve, variation of number of nerval orifice, and existence of communicating branch of nerve, and so on.