射频热凝术治疗原发性三叉神经痛的临床研究

Clinical study of radiofrequency thermocoagulation in the treatment of primary trigeminal neuralgia

目的评价射频热凝术治疗原发性三叉神经痛的近、中期临床疗效及安全性。方法将63例原发性三叉神经痛患者随机分成:治疗组(31例)及对照组(32例),治疗组采用数字减影脑血管造影(DSA)机引导下射频热凝术治疗,对照组采用常规药物治疗或封闭方法治疗,分别观察2组的临床疗效,并对治疗组中期疗效进行随访。结果治疗组总有效率96.8%,优良率61.3%,无严重不良反应发生,明显优于对照组总有效率65.6%、优良率28.1%,差异有统计学意义(χ2=9.91、7.01,P<0.01),治疗组术后中期的临床疗效随访,总有效率仍为96.8%,2例复发,占6.5%,经第2次射频热凝术治疗完全止痛。结论 DSA机引导射频热凝治疗原发性三叉神经痛穿刺成功率高,近、中期临床疗效确切,安全性高。

Objective To evaluate the clinical efficacy and safety of DSA - guided radiofrequency themocoagulation on the treatment of primary trigeminal neuralgia in short - and mid - term prospect. Methods 63 cases of primary trigeminal neuralgia were randomly and divided into two groups, including the patients treated with radiofrequency themocoagulation （ n = 31 ） , and those in control gToup （ n = 32 ） who treated with drugs or trigeminal nerve block. Clinical efficay was compared between the two groups, and the patients in treated with radiofrequency themocoagulation group were followed up for 24 hours to 6 months. Results The effective rate with radiofrequency themocoagulation was 96.8% ,and the satisfactory rate was 61.3% , whereas it was 65.6% and 28.1% in the control group. The patients were followed - up survery 1 year after radiofrequency themocoagulation, and the effective rate was 96.8%, 2 patients recurrenced andretreated with radio- frequency thermocoagulation, the recurrence rate was 6.5%. Conclusion DSA - guided radiofrequeney thermocoagulation on the treatment of primary trigeminal neuralgia is effective and safe in short - and mid - term prospect.