复发性三叉神经痛的伽玛刀放射外科治疗分析

The clinical study on gamma knife radiosurgery for recurrent trigeminal neuralgia

目的研究伽玛刀放射外科治疗复发性三叉神经痛的有效性和安全性。方法回顾性分析对曾经接受过微血管减压术（MVD）,伽玛刀放射外科（GKRS）,射频（RF）或封闭治疗后疼痛复发的患者59例,并与同期未行上述治疗的28例患者进行对比分析,评价患者经GKRS治疗后的疼痛控制率及并发症发生率。结果伽玛刀治疗后平均随访时间33个月（8-62个月）。疼痛控制有效率在MVD组为69.2%;GKRS复发组为83.3%;RF组为87.5%;封闭组为75.0%;GKRS组为89.3%;各组之间无统计学差异（P=0.516）。面部感觉异常发生率在MVD组为15.4%;GKRS复发组为33.3%;RF组为25.0%;封闭组为25.0%;GKRS组为14.3%;各组之间无统计学差异（P=0.579）。结论伽玛刀放射外科治疗三叉神经痛疗效确切,不良反应发生率低,是TN复发患者的较好的治疗方式。

Objective To assess the safety and efficacy of gamma knife radiosurgery for treatment of recurrent trigeminal neuralgia（TN）.Methods Retrospectively analyzed 59 recurrent trigeminal neuralgia patients who had ever received microvascular decompression（MVD）,gamma knife radiosurgery（GKRS）,radiofrequency（RF）or block therapy,and 28 new TN patients were compared at the same time.The safety and efficacy were assessed after they received GKRS.Results The mean follow-up time were 33months（8-62months）.The pain control efficiency in the MVD group,GKRS recurrence group,RF group,block group and GKRS group was 69.2%,83.3%,87.5%,75.0%and 89.3%,repectively.No significant difference among the groups（P=0.516）.Facial sensory dysfunction occurred in the MVD group,GKRS recurrence group,RF group,block group and GKRS group was 15.4%,33.3%,25.0%,25.0%and 14.3%,repectively.There are no significant difference were found（P=0.579）.Conclusion Gamma knife radiosurgery is a safe and effective treatment method for recurrent TN.