老年人原发性三叉神经痛得宝松局部注射治疗效果评价

Clinical study of treating primary trigeminal neuralgia of aged people by local injection of Diprospan

目的:探讨得宝松(复方倍他米松)局部注射治疗老年人原发性三叉神经痛的临床效果,为三叉神经痛提供新的治疗方法。方法:原发性三叉神经痛患者30例,根据疼痛范围行相应神经支局部注射,每个注射点注入得宝松灭菌混悬注射液0.5ml。治疗后3个月内定期复诊,随访时间3年,使用视觉模拟评分法评定患者疼痛程度和治疗效果。结果:30例患者治疗后1个月内三叉神经痛症状有不同程度的减轻,VAS评分疗效优、良、中者分别为43.3%、46.7%和10.0%,治疗后3年VAS评分疗效优、良、中、差者分别为33.3%、40.0%、16.7%和10.0%,3年内复发率为10.0%,平均复发时间分别为26个月,治疗后VAS评分与治疗前相比有显著性差异。患者治疗后无明显感觉降低。结论:得宝松局部注射治疗三叉神经痛方法简单,有效率高,复发率低,无明显毒副作用,是一种安全有效的治疗方法。

Objective： This study is carried out to explore the clinical efficacy of local injection of Diprospan （compound betamethasone） in treating primary trigeminal neuralgia of the aged, and to provide new method of treating trigeminal neuralgia. Methods： Thirty （30） aged patients with primary trigeminal neuralgia were selected and locally injected with diprospan according to the scope of nerve pain. 0.5 ml of sterile suspension of diprospan was injected in each injection point. Patients returned for routine visit in 3 months after treatment, and were followed up for 3 years. The pain degree and efficacy of treatment were evaluated by Visual Analogue Scales （VAS）. Results： The symptoms of trigeminal neuralgia in 30 patients were relieved more or less in 1 month after treatment, with the VAS scores of 43.3%, 46.7% and 10% for excellent, good, and effective respectively. The VAS scores were 33.3%, 40%, 16.7% and 10% for excellent, good, effective and fail respectively in 3 years after treatment. The recurrence rate was 10% in 3 years. Mean recurrence time was 26 months. The VAS score after treatment was significantly different from that before treatment. The senses of patients were not obviously decreased after treatment. Conclusion ：Trigeminal neuralgia can be treated by local injection of diprospan in a simple and efficient way, with low recurrence rate, without any obvious toxicity or side effect. This treating method is proved to be safe and efficient.