三叉神经痛微血管减压术治疗现状

Treatment status of microvascular decompression on treating trigeminal neuralgia

三叉神经痛是临床常见的一种神经痛,具有阵发性、单边性、撕裂样、短暂性疼痛,一般数秒或数分钟后自行缓解的特点,这是由于三叉神经入根区存在血管压迫或三叉神经入根区被增厚的蛛网膜束裹,导致脱髓鞘病变而异常放电,右侧发病率高于左侧。目前针对三叉神经痛的治疗方式有很多,微血管减压术是治疗方法之一,也是国际上公认的治疗三叉神经痛的首选治疗方法,其原理为解除责任血管和增厚的蛛网膜对三叉神经入根区的压迫,具有治疗效果最明显,并发症最少的特点。微血管减压术要求操作精细,在不损伤神经的前提下充分神经减压,术中特别注意保护面、前庭神经和延静脉,以减少并发症和避免再次复发。现从三叉神经微血管减压术的发展、手术要领、并发症等方面进行阐述。

Trigeminal neuralgia is one of clinical common neuralgia disease, having the characteristics of paroxysmal, unilateral, tearing, temporary pain, and can relief in a few seconds or minutes, which is due to the trigeminal nerve root zone compressed by vascular or wrapped by arachnoid bundle, resulting into the demyelinating lesions caused by abnormal discharge, and the right side of the incidence is higher than the left. The treatment methods of trigeminal neuralgia are so many today. However, microvascular decompression is one of the treatments, and has been recognized as the first choice for treatment of trigeminal neuralgia. Its principle is to remove responsible blood vessels and thicken the arachnoid in the root zone. Microvascular decompression is one of the fine operation, first, nerve decompressing is thoroughly on the premise of no damage nerves, second, special attention should be paid to protect the surface and vestibular nerve and vein in the operation, in order to reduce complications and avoid recurrence. Now, we introduced the development of the trigeminal nerve microvascular decompression, operation essentials and complications.