伽玛刀治疗原发性三叉神经痛远期疗效分析(附33例报道)

Gamma knife radiosurgery for primary trigeminal neuralgia:analysis of long-term treatment effect

目的分析伽玛刀放射外科治疗原发性三叉神经痛的远期疗效和并发症的发生情况。方法应用Leksell伽玛刀治疗了33例原发性三叉神经痛患者,进行长期的随访(全部都在5年以上,最长超过8年,平均75.7个月),详细记录其疼痛的缓解情况,以及发生的并发症、服用药物、复发等。结果首次治疗后有效率90.9%,5年以上的远期随访有效率78.8%;复发率13.3%,复发的患者再次行伽玛刀治疗仍能取得良好的效果;远期随访并发症发生率15.1%,但均较轻微并能被患者接受。结论伽玛刀治疗原发性三叉神经痛远期随访疗效肯定,并发症较轻且发生率低,可以作为多数患者的首选治疗方法。

Objective To analyze the treatment effect and complications of stereotactic gamma knife radiosurgery for primary trigeminal neuralgia for long-term follow-up. Methods We treated 33 primary trigeminal neuralgia with Leksell gamma knife whom were followed up for long term （all above 5 years, the longest more 8 years, and 75.7 months average） ,and recorded in detail their degree of pain relief, medicine taken, reoccurrence and complications suffered. Results The percentage of patients who achieved pain free or relieved significently was 90,9 % after first treatment,78.8% for the long-term follow-up. The reoccurrence rate was 13.3 % ,and the reoccurred patients could still achieve good results after repeated gamma knife treatment. Complications occurred in 15.1% of patients, but all were light and could be accepted by patients. Conclusion The gamma knife performed on idiopathic trigeminal neuralgia could achieve good results for long term, and complications were light and occurred in low rate. For most of the patients of primary trigeminal neuralgia, we recommend gamma knife be the first choice of treatment.