经卵圆孔与经翼腭窝射频温控热凝治疗原发性三叉神经痛临床分析

Comparison of radiofrequency thermocoagulation through oval foramen and pterygopalatine fossa in the treatment of idiopathic trigeminal neuralgia

目的观察经卵圆孔与经翼腭窝射频热凝治疗原发性三叉神经痛(上颌神经)的疗效及不良反应。方法 30例原发性三叉神经痛(上颌神经)患者随机分为A组和B组,每组15例,A组运用经卵圆孔射频热凝治疗原发性三叉神经痛(上颌神经),B组采用经翼腭窝射频热凝治疗原发性三叉神经痛(上颌神经),观察治疗前后的视觉模拟评分(VAS)、患者满意度评分(PSS)、不良反应以及6个月内的预后情况。结果两组治疗后组内VSA均明显降低(P<0.05),但两组差异无统计学意义(P>0.05);两组治疗后组内PSS均明显增高(P<0.05),两组差异亦无统计学意义(P>0.05);随访6个月,两组疗效相似,但A组的不良反应明显高于B组。结论相比经卵圆孔射频热凝治疗原发性三叉神经痛而言,经翼腭窝射频热凝治疗原发性三叉神经痛是一种更安全及不良反应少的方法。

Objective To evaluate the efficacy and side-effect of radiofrequency thermocoagulation through oval foramen and pterygopalatine fossa in the treatment of idiopathic trigeminal neuralgia（maxillary nerve）.Methods 30 patients with idiopathic trigeminal neuralgia（maxillary nerve） were included.The patients were randomly assigned to the two groups（Group A and B）.Each patient in the Group A was treated with radiofrequency thermocoagulation through oval foramen,whereas each patient in the Group B was treated with radiofrequency thermocoagulation through pterygopalatine fossa.Evaluation parameters were pain intensity using a Visual Analogue Scale（VAS）,patient satisfaction using a Patient Satisfaction Scale（PSS）,additional side effects and complication related to the technique.Results The VAS scores decreased significantly（P0.05） and PSS improved significantly（P0.05） after the procedure in both Group A and Group B,respectively.Follow-up 6 months,the efficacy of the two groups were similar,but Group B was less side-effect than Group A.Conclusion Radiofrequency thermocoagulation through pterygopalatine fossa is effective for treatment of idiopathic trigeminal neuralgia（maxillary nerve）,with less side-effect.