经皮穿刺球囊压迫与显微血管减压术治疗老年人三叉神经痛的疗效及安全性

Efficacy and safety of percutaneous balloon compression and microvascular decompression in the treatment of trigeminal neuralgia in the elderly

目的探讨经皮穿刺球囊压迫(PBC)与显微血管减压术(MVD)治疗老年原发性三叉神经痛的临床疗效及安全性。方法回顾性分析2019年1月至12月周口市中心医院分别采用MVD(25例,MVD组)或PBC(28例,PBC组)治疗的老年三叉神经痛患者的临床资料,采用χ^(2)检验或Fisher确切概率法比较2组患者的手术疗效及并发症的差异,采用t检验比较2组患者住院时间、住院费用的差异。结果PBC组患者与MVD组患者手术治愈率(67.9%vs68.0%)、有效率(85.7%vs96.0%)比较,差异均无统计学意义(P均>0.05),PBC组手术时间明显较MVD组短[(56±17)minvs(141±29)min],住院时间较MVD组短[(6±2)dvs(16±5)d],且住院费用较MVD组少[(24110±5941)元vs(27648±5523)元],差异均具有统计学意义(t=6.277、9.199、0.615,P<0.001、<0.001、=0.030)。PBC组患者面部麻木、面部肿胀、三叉神经抑制反应发生率高于MVD组患者[85.7%(24/28)vs8.0%(2/25);21.4%(6/28)vs0;21.4%(6/28)vs0],而术后发热反应发生率低于MVD组患者[0vs76.0%(19/25)],差异均具有统计学意义(P<0.001;χ^(2)=4.095,P=0.043;χ^(2)=4.095,P=0.043;χ^(2)=33.172,P<0.001)。结论MVD及PBC手术均能有效治疗老年患者原发性三叉神经痛,与MVD手术相比,PBC手术治疗原发性三叉神经痛更简便、安全。

ObjectiveTo investigate the clinical efficacy and safety of percutaneous balloon compression(PBC)and microvascular decompression(MVD)in the treatment of primary trigeminal neuralgia in the elderly.MethodsThe clinical data of elderly patients with trigeminal neuralgia treated with MVD(25 cases)or PBC(28 cases)from January 2019 to December 2019 were retrospectively analyzed.The chi-square test or Fisher exact probabilities was used to compare the surgical efficacy and complications between the two groups,and thet-test was used to compare the length of stay and hospitalization costs between the two groups.ResultsThere was no significant difference between PBC group and MVD group in surgical cure rate(67.9%vs68.0%),and effective rate(85.7%vs96.0%)(allP>0.05).The operation time of PBC group was significantly shorter than that of MVD group[(56±17)min vs(141±29)min,t=6.277,P<0.001];the length of hospital stay was shorter than that of MVD group[(6±2)dvs(16±5)d,t=9.199,P<0.001],and the hospitalization cost was lower than that of MVD group[(24110±5941)yuan vs(27648±5523)yuan,t=0.615,P=0.030].The incidence of facial numbness,facial swelling and trigeminal nerve inhibition in the PBC group were higher than those in the MVD group[85.7%(24/28)vs8.0%(2/25);21.4%(6/28)vs0;21.4%(6/28)vs0],while the incidence of postoperative febrile reaction was lower than that in the MVD group[0vs76.0%(19/25)],the differences were statistically significant(P<0.001;χ^(2)=4.095,P=0.043;χ^(2)=4.095,P=0.043;χ^(2)=33.172,P<0.001).ConclusionBoth MVD and PBC surgery can effectively treat primary trigeminal neuralgia in elderly patients.Compared with MVD surgery,PBC surgery is simpler,safer and more effective in the treatment of primary trigeminal neuralgia.