微血管减压术治疗三叉神经痛2643例临床分析

Clinical analysis of 2643 cases of trigeminal neuralgia treated by microvascular decompression

目的评价微血管减压术治疗三叉神经痛的临床疗效.方法回顾分析微血管减压术治疗三叉神经痛2643例的手术经验及术中所见.结果 2643例中治愈2487例,显效76例,有效48例,无效31例,死亡1例.2136例得到3～240个月随访,有1918例治愈,85例显效,39例有效,30例无效,64例疼痛复发(其中有37例行第2次手术后治愈).结论异常血管压迫三叉神经入根区,神经根周围蛛网膜增厚粘连是三叉神经痛的病因,行该区粘连的蛛网膜分离后,微血管减压是治疗三叉神经痛的有效方法.

Objective To evaluate the clinical effects of microvascular decompression in treating trigeminal neuralgia. Methods Surgical experience and operative findings of 2643 cases of trigeminal neuralgia treated by microvascular decompression were analyzed retrospectively. Results Two thousand four hundred and eighty-seven of 2643 cases were cured,76 cases were ineffectiveness,48 cases were effectivenss and 31 were ineffective. One patient died. Two thousand one hundred and thirty-six cases were follwed up in 3-240 months,1918 cases were cured, 85 cases were obviously effective, 39 cases were effective and 30 were ineffective. Sixty-four cases were pain relapsed and 37 cases were cured by second operation among them. Conclusion The etiology of trigeminal neuralgia is that the unusual vascular oppress the root entry zone, and arachnoid membrane circling the nerve is thickened and sticked. To untie the arachnoid membrane and decompress the offending vascular is the effective methods in treating trigeminal neuralgia.