静脉压迫致三叉神经痛的临床特点

Diagnosis and surgical treatment of trigeminal neuralgia compressed by the vein

目的 探讨单独静脉压迫三叉神经根致三叉神经痛病人的临床特点及手术治疗方法。 方法 在2200例三叉神经痛手术病例中，对76例单独静脉压迫致三叉神经痛者，术中根据静脉的走行与回流方向分为4型，分别采用双极电凝后剪断、锐性分离后减压等方法进行治疗，并长期跟踪随访。 结果 单独静脉压迫致三叉神经痛与动脉压迫者有不同特点，术后早期疼痛治愈率较动脉压迫者低。但1～2周后多疼痛逐渐消失而痊愈，且长期随访无复发。 结论 静脉压迫三叉神经根是三叉神经痛的致病 原因之一，静脉可以是直接的责任血管。术中根据静脉的不同分型采取不同处理方法，只要分离彻底、减压充分，多能取得良好的手术效果，不必加行三叉神经感觉根部分切断术。

Objective To study the clinical characteristics and surgical methods of trigeminal neuralgia compressed by the vein alone． Method 76 cases compressed by the vein alone of 2200 patients with trigeminal neuralgia were divided to four type according to the posistion and reflux direction of vien, and were treated by cutting after electrocoagulation and decompression after sharp separation． Result These cases compressed by the vien alone are different from those compressed by the artery． The early postoperative cure rate is lower than that of compressed by the artery． But after 1－2 week, multiple cases were cured gradually and followed up with no recurrence． Conclusion The vein comprerrion is one of the reasons of trigeminal neuralgia． The vein may be the single responsibilitive vascular． If different methods are used according to different typle of vien in the operation with exhaustive thoroughly and decompression fully, operative efficacy is satisfied and retrogasserian rhizotomy partly is no necessary．