微血管减压术治疗三叉神经痛的随访观察

Therapeutic effect of microvascular decompression on primary trigeminal neuralgia： a follow-up study

目的探讨乙状窦后入路微血管减压术（MVD）治疗原发性三叉神经痛的临床价值。方法回顾性分析MVD治疗的769例原发性三叉神经痛患者的临床资料，对治疗结果进行分析讨论。结果769例三叉神经痛患者中，743例治愈，17例有效，9例无效，无手术死亡。随访6～180个月，46例复发，其中9例行二次手术治愈。结论MVD治疗原发性三叉神经痛安全、有效，术中创伤小，复发率低，可作为原发性三叉神经痛的首选治疗方法。

Objective To study the clinical value of microvascular decompression （MVD） through the retrosigrnoid approach in the treatment of primary trigeminal neuralgia. Methods The clinical data of 769 patients with primary trigeminal neuralgia undergoing MVD through the retrosigrnoid approach was retrospectively analyzed to evaluate the therapeutic effect of the treatment. Results MVD was accomplished in 769 patients with primary trigeminal neuralgia. Neuralgia was totally relieved in 743 patients, significantly relieved in 17 patients and not relieved in 9 patients after the treatment. Operative mortality occurred in none of the cases. The patients were followed up for 6 to 180 months, during which period 46 patients were found to experience recurrent neuralgia, and 9 of them were cured after a second operation. Conclusion MVD is a safe and effective surgical approach causing minimal invasiveness and lower recurrence rate, and can serve as the primary option for treatment of primary trigeminal neuralgia.