螺旋CT引导精确穿刺射频温控热凝术治疗经典型三叉神经痛的临床应用

Clinical application of spiral CT - guided precise puncture of foramen ovale for the treatment of classical trigeminal neuralgia by radiofrequency thermocoagulation

目的探讨螺旋CT引导经卵圆孔穿刺射频温控热凝术治疗经典型三叉神经痛的快速精确穿刺方法。方法收治确诊的经典型三叉神经痛57例，经螺旋cT引导定位，穿刺针经卵圆孔至三又神经半月神经节，进行射频温控热凝治疗。结果所有患者均在短时间内一次性穿刺成功，治疗后7天、3个月疼痛强度评分（NRS）均较术前明显降低（P〈0．05）。三又神经痛完全缓解52例（91．23％），明确缓解3例（5．26％），中度缓解2例（3．51％）。无严重并发症。结论螺旋CT引导精确穿刺射频温控热凝术治疗经典型三叉神经痛，定位精确，穿刺快速，确保成功，避免了多次穿刺对针道周围组织的损伤。

Objective To investigate the fast and accurate method of spiral CT - guided foramen ovale （FO） puncture for the treatment of classical trigeminal neuralgia by radiofrequency thermocoagulation. Mothods 57 cases of classi- cal trigeminal neuralgia were treated by radiofrequeney thermocoagulation therapy using spiral CT - guided positioning of the needle through the FO to the trigeminal ganglion. Results Successful FO puncture at first attempt was perfolaned in a short time on all patients. The Numeric Rating Scale （NRS） at 7 days and 3 months after the treatment was significant- ly lower than before operation （P 〈 0.05 ）. Complete pain relief was accomplished in 52 cases （9l. 23% ） , clear pain relief in 3 cases （5.26%） , moderate pain relief in 2 cases （3.51%）. No serious complications were observed. Conclu- sion Spiral CT -guided precise FO puncture for the treatment of classical trigeminal neuralgia by radiofrequency thermocoagulation has the advantage of accurate positioning and fast puncture with high success rate, so it can avoid damage to the surrounding tissue of the needle tract caused by repeated punctures.