三叉神经痛微血管减压术后复发原因分析及对策

The cause analysis and countermeasure of recurrent trigeminal neuralgia after microvascular decompression

目的分析三叉神经痛微血管减压术后复发原因及对策。方法对11例三叉神经痛复发病例进行再手术探查,10例进行了微血管再减压术,1例进行了感觉根部分切断术。结果术后全部随访,时间6-60个月。术后患者疼痛缓解。1例行三叉神经感觉根部分切断患者术后存在神经支配区感觉减退。无复发及严重并发症。结论熟练掌握三叉神经解剖,充分松解蛛网膜,操作轻柔,可靠而充分的隔离,尽量使隔离棉及责任血管远离神经,可以降低微血管减压术后复发,而粘连引起的复发以感觉根部分切断术为主。

Objective to investigate the cause and countermeasures of recurrent trigeminal neuralgia after microvascular decompression. Methods To operate exploration 11 cases of micro vascular decompression for trigeminal neuralgia with recurrence, 10 cases were carried out for microvascular decompression and 1 cases carried out part of the cut feels the root . Results All patients were followed up for 6-60months after operation. The pain in all patients relieve after operation. The patients＂ inner vation area feel drop after operation of part of cut feels the root. Conclusion To master anatomy of trigeminal neuralgia,and to loose arachnoid membrance fully and softly,we can make responsible vessel and isolated cottun away from trigeminal. As a result, we can reduce recurrence of microvascular decompression, recurrence in caused by adhesions can be cured by part of the cut feels of the root.