经翼腭窝与经卵圆孔上颌神经介入射频热凝术治疗原发性三叉神经痛的临床疗效比较

CLINICAL EFFICACY?OF?RADIOFREQUENCY THERMOCOAGULATION TREATMENT OF MAXILLARY NERVE VIA SPHENOPALATINA FOSSA OR FORAMEN OVALE ON PRIMARY TRIGEMINAL NEURALGIA

目的 :经随机双盲对照分析,对经翼腭窝与经卵圆孔上颌神经射频热凝术治疗三叉神经痛进行临床疗效比较。方法 :2004年1月-2008年6月,50例顽固性三叉神经上颌支疼痛患者被纳入,并且随机分成A、B两组。分别在数字减影血管造影(digital subtraction angiography,DSA)介导下进行经翼腭窝(A组)或经卵圆孔(B组)上颌神经射频热凝术。利用视觉模拟评分法(visual analoguescores,VAS)、患者满意度评分(patient satisfaction score,PSS)进行术前与术后不同时段疗效评定。同时记录手术副作用、并发症发生情况及复发率。随访时间为24个月。结果 :经翼腭窝与经卵圆孔上颌神经射频热凝术治疗三叉神经痛,术后VAS评分均明显下降(P<0.05),术后患者满意度高。术后临床疗效、副作用和术后复发率,两组患者相比无明显差异。在并发症方面,经翼腭窝组少于卵圆孔组(P<0.05)。结论 :经翼腭窝与经卵圆孔上颌神经射频热凝术相比,两者均具有定位确切、操作方便和有优良的临床疗效,但前者手术并发症较少于后者。

Objective： To compare the clinical efficacy of radiofrequency thermocoagulation treatment of maxillary nerve via sphenopalatina fossa and via foramen ovale on primary trigeminal neuralgia（TN） by a random,double blinded method.Methods： From Jan 2004 to Jun 2008,50 patients with intractable TN were enrolled into this study and were randomly divided into group A and group B.Under the guidance of digital subtraction angiography（DSA）,group A were treated with radiofrequency thermocoagulation via sphenopalatina fossa,while group B underwent radiofrequency thermocoagulation via foramen ovale.Efficacy was evaluated using visual analog scores（VAS） and patient satisfaction score（PSS）;Side effects and complications with the surgery were recorded for 24 months after operation.Results： Compared with pre-operation value,VAS decreased significantly after operation in two groups（P 0.05）.There were no significant differences between the two groups in terms of clinical effects,side effect and recurrence rate;but group A had less complications than group B（P 0.05）.Conclusion： Both radiofrequency thermocoagulation treatment of maxillary nerve via sphenopalatina fossa and via foramen ovale have the same efficacy.Compared with foramen ovale,the treatment via sphenopalatina fossa has less complications for patients with TN.