简易三叉神经定向仪(DC-Ⅲ型)的临床应用

A simple trigeminus stereoguide apparatus (type DCⅢ) for clinical application

目的：为了治疗三叉神经痛，获得好的解痛疗效，减少术中疼痛、术后并发症和复发率。我们研制成ＤＣ－Ⅲ型简易三叉神经定向仪供临床应用。方法：自１９９２年６月至１９９６年１２月，采用立体定向引导下经皮半月神经节后根甘油注射治疗三叉神经痛２００例。从颅底Ｘ线摄片上测算卵圆孔的立体坐标数值，将定向仪固定在双侧颧弓上。在立体定向导引下，可顺利地把针经卵圆孔穿入三叉神经池，缓慢注射９９．５％甘油（０．２～０．４ｍｌ）。结果：术后一个月内的近期解痛率９８％；随访１７０例，期限６～３６个月，平均２５个月，远期解痛率９１．７％，无严重并发症及死亡。结论：此手术的主要优点是：解痛效果佳，无严重感觉缺失及眼角膜的并发症。手术技术简易。

 Objective:We have designed a simple trigeminus stereoguide apparatus (Type DCⅢ) for treatment of trigeminal neuralgia in order to obtain a better pain relief result and to reduce intraoperative pain, postoperative complication and recurrence rate. Methods:Over the period from June 1992 to December 1996, 200 patients with trigeminal neuralgia underwent percutaneous retrogasserian glycerol rhizotomy (PRGR) with the trigeminus stereoguide apparatus. Base skull (submentovertical) Xray film was taken for measuring stereotactic coordinate of foramen ovale. Then trigeminus stereoguide apparatus was fixed on bilateral zygomatic arch. Under the stereotactic guiding, the puncture needle was passed through foramen ovale to the trigeminal cistern. 99.5% glycerol (0.2～0.4ml) was slowly injected. Results:Within one month postoperatively, the pain relief rate was 98%. Over a fellowup period (mean 25 months, range 6～36months) the longterm pain relief rate was 91.7% in 170 patients. There were no severe complications and death. Conclusion:The main advantage of the procedure is the good painfree result, exceptionally severe dysaesthesia, the rarity of corneal complication. This study shows that PRGR is efficacious and technically easy. 