老年原发性三叉神经痛微血管减压术

Microvascular decompression for idiopathic trigeminal neuralgia in elderly patients

目的探讨老年原发性三叉神经痛微血管减压术（microvascglar decompression，MVD）的安全性和特殊性。方法对49例老年（年龄≥65岁）原发性三叉神经痛病人（老年组）及64例非老年（年龄〈65岁）病人（对照组）的MVD疗效及预后进行相关统计学分析。结果老年组和对照组术后疼痛完全缓解率分别为87．8％和90．6％，术后有效率分别为95．9％和95．3％；术后短期内效果两组无统计学差异（P〉0．05）。老年组无严重并发症及死亡病例，并发症发生率16．3％，与对照组（17．2％）无明显差别（P〉0．05）。但老年组术后不良反应发生率明显高于对照组（P〈0．05）。结论老年病人和中青年病人的MVD手术效果和并发症情况基本相同。年龄并非影响MVD手术效果和预后的绝对因素，年龄≥65岁并未非常显著增加手术并发症的发生率。对于整体状况良好的65—75岁之间的老年病人，主张积极采用MVD。

Objective To explore the safety and specificity ofmicrovascular decompression （MVD） for idiopathic trigeminal neuralgia in elderly patients. Methods The postoperative outcome and prognosis of 49 elderly patients （≥ 65 years, older group） and 64 nonelderly patients （〈 65 years, control group） undergoing MVD were analyzed statistically. Results The complete remission rate of trigeminal neuralgia and efficacy rate was 87.8% and 95.9% in older group, 90.6% and 95.3% in control group respectively. There was no statistically significant difference was observed between the two groups in the postoperative short-term efficiency （P〉 0.05）. Postoperative complication rate was 16.3% in the older group, and there was no statistically significant difference with the control group （17.2%, P 〉 0.05）. The adverse effect rate was significantly higher in the older group than in the group control （P 〈 0.05）. Conclusions There are no significant differences in postoperative outcome and complication rate between elderly and nonelderly patients. The age is not a determinant factor for MVD results, and the postoperative complication rate would not increase with age. For elderly patients between 65-75 years old in good physical condition, the application of MVD should be advocated.