C型臂下选择性射频热凝治疗原发性三叉神经痛

SELECTIVE RADIOFREQUENCY THERMOCOAGULATION GUIDED WITH C ARM X RAY FLUOROSCOPY POSITIONING FOR TREATMENT OF TRIGEMINAL NEURALGIA

目的:探讨C型臂定位下选择性射频热凝治疗原发性三叉神经痛的临床价值,并对其中、远期疗效进行评估。方法:选择82例原发性三叉神经痛患者,在C臂X光机定位下,对半月神经节进行选择性射频毁损治疗,温度分别设定为70℃、80℃、86℃,时间均为60s。术后行近期疗效评定、观察不良反应,并对中、远期疗效进行电话随访。结果:82例患者穿刺成功率100%,术后近期所有患者疼痛缓解,并发角膜炎1例(发生率1.22%)。术后成功电话随访40例,9例复发(复发率22.5%)。结论:C型臂定位下选择性射频热凝治疗原发性三叉神经痛,是一种微创、安全、有效、经济的治疗方法,中、远期复发病例可再次治疗获得疼痛缓解。

Objective ： To assess the efficacy of radiofrequency thermocoagulation on the treatment of primary trigeminal neuralgia guided with C arm X ray fluoroscopy in short-term, mid-term, and long-term prospect. Methods： 82 cases were positioned by X ray fluoroscopy, then treated with radiofrequency thermocoagulation. Temperatures were set at 70℃ ,80℃ and 86℃, respectively. The thermocoagulation duration was 60 seconds. The outcomes of short-term and side effects were observed nearly post-treatment. The effects in mid-term and long-term prospect were assessed in secondary follow-up. Results： All the cases got an immediate pain relief and one case had keratitis after procedure （ 1.22% ）. During the follow up, 40 patients were visited. 9 patients reoccurred （22.5 % ）. Conclusion ： Selective radiofrequency thermocoagulation guided with C arm X fluoroscopy for the treatment of trigeminal neuralgia is a minimally invasive, safe, and effective method, the recurred cases in mid-term and long-term post-treatment might get satisfactory effects with repeat procedures.