原发性三叉神经痛微血管减压手术探讨

Microvascular Decompression in Idiopathic Trigeminal Neuralgia

目的探讨原发性三叉神经痛微血管减压术治疗方法及效果。方法对32例原发性三叉神经痛患者在显微镜下实施微血管减压术,并讨论其发病机制、手术方法及手术注意事项。结果术中压迫三叉神经的血管包括小脑上动脉(25例)、小脑前下动脉(6例)和静脉(1例);32例患者术后疼痛完全缓解26例,6例仍有轻微疼痛。术后出现短时期眩晕13例,单纯疱疹者5例,术后面部麻木4例,同侧听力下降2例,无死亡和严重并发症发生,随访无复发病例。结论微血管减压术是治疗原发性三叉神经痛安全、微创、有效的方法,提高显微外科操作技术,不遗漏责任血管,是提高手术疗效和减少并发症的关键。

Objective To explore the effect of microvascular decompression（MVD） on idiopathic trigeminal neuralgia （ITN）.Methods Thirty-two ITN patients were given MVD under microscope,and its pathogenesis,surgical methods and considerations discussed.Results The blood vessels compressing trigeminal nerve included superior cerebellar arteries （25 cases）,anterior inferior cerebellar arteries （6 cases）,veins （1 case）.In 32 patients,26 remitted completely,6 had slight pains after operation.Short dizziness occurred in 13,herpes simplex in 5,postoperative facial numbness in 4,ipsilateral hearing loss in 2,no death or severe complications occurred,and no recurrence case was found in follow-ups.Conclusion MVD,a safe,microinvasive and effective method for ITN,is the key of improving effectiveness and reducing complications.