显微手术治疗老年性三叉神经痛的术式探讨及疗效分析

To investigate the modus operandi and analyze therapeutic effect of The microsurgical treatment of elder patients with trigeminal neuralgia

目的探讨老年人三叉神经痛显微神经外科手术的术式选择。方法回顾本科2000～2007年112例60岁以上老年三叉神经痛病例,分析手术方式、疗效及并发症。结果微血管减压手术(MVD)47例,有效45例,复发3例,面部麻木8例;三叉神经感觉根部分切断术(PR)34例,有效34例,无复发,面部麻木34例;微血管减压术+感觉根部分电凝处理31例,有效31例,无复发,面部麻木26例。结论治疗存在血管压迫的老年人三叉神经痛,可采取MVD后对三叉神经感觉根部分电凝,较单纯MVD可降低远期复发率,术后造成的面部麻木无三叉神经感觉根部分切断术典型。

Objective To study the microsurgical treatment of elder patients with trigemi nal neuralgia. Methods The clinical records of 112 patients with ages ranging from 60477 with trigeminal neuralgia undergoing microsurgical treatment were analyzed. Results Of 47 patients treated by microvascular decompression（MVD） 45 were cured or significantly improved , 3 suf- fered from facial numbness and 3 suffered from recurrence during longterm follow--up. Of 34 patients treated by partial rhizomoty（PR） of sensory root of trigeminal nerve 34 were cured or significantly improved but sufferd from facial numbness. And there was no recurrent case. Of 31 patients treated by MVD and partial electrocoagulation 31 were cured or significantly improved, 26 were suffered from facial numbness. And there was also no recurrent case. Conclusion Partial electrocoagulation to sensory root of trigeminal nerve after MVD could reduce longterm recurrence rate compared with simple MVD and alleviate the symptoms of facial numbness compared with PR.