颅底CT重建加神经电生理联合引导射频治疗三叉神经痛(附28例临床分析)

Selective radiofrequency thermocoagulation under the guidance of skull base 3D-CT combined with electrophysiology for trigeminal neuralgia

目的探讨颅底CT重建加神经电生理联合引导方法射频治疗三叉神经痛的疗效。方法采用Hartel前入路穿刺法,在颅底CT重建加神经电生理联合引导下,运用射频治疗28例原发性三叉神经痛患者。结果28例全部穿刺成功,无穿刺并发症发生,全部患者一次止痛。随访4年,1年复发1例,2年复发2例,3年复发3例,共复发6例。结论颅底CT重建加神经电生理联合引导射频治疗三叉神经痛操作简单、安全性高、创伤小、疗效确切,可作为外科治疗三叉神经痛的首选方法。

Objective To analyse the treatment results of selective radiofrequency thermocoagulation under 3D-CT guidance combined with electrophysiology for trigeminal neuralgia. Methods Through anterior-lateral facial （Hartel）approaches, selective radiofrequency thermocoagulation were performed in 28 patients with trigeminal neuralgia by the guidance of skull base- CT confused with neurophysiology methods. Results All 28 patients were successfully punctured with the Hartel approach, and no complication caused by the puncture had been found. All the patients acquired pain-relieve at the first-time of therapy with this methods and only 6 patients were relapsed during 4 years follow up, One patients relapsed in the first year after the treatment, two patients in the second year, and three in the third year. Most of the patients achieved excellent or good pain-relieve after treated by these approaches. Conclusion Selective pereutaneous radiofrequency thermocoagulation under the guidance of skull base 3D-CT combined with electrophysiology for trigeminal neuralgia is a method with more effective pain-relieve, less pain recurrence rate, more security and less injuries, and it can be used as a better methods in the treatment of the primary trigeminal neuralgia.