CT引导下经圆孔外口与经卵圆孔射频治疗三叉神经上颌神经痛的临床疗效比较

Comparison of Effect of CT Guided Percutaneous Puncturing through Foramen Rotundum and Oval Foramen for Radiofrequency Thermocoagulation to Treat Primary Trigeminal Maxillary Neuralgia

目的比较CT引导下经圆孔外口与经卵圆孔行温控射频热凝术治疗原发性三叉神经上颌神经痛的临床疗效。方法选取2012年10月至2013年6月间我科室收治的60例原发性三叉神经上颌神经痛患者,采用入院顺序单双号将患者分为单号组(A组)和双号组(B组)。A组采用侧方入路穿刺圆孔外口行温控射频热凝上颌神经。B组采用Hartel前入路法穿刺卵圆孔行半月神经节温控射频热凝术。患者均知情同意并签署知情同意书。观察患者术后6个月临床疗效、并发症发生情况,并对中期疗效及复发率进行随访。结果 60例患者治疗后疼痛均明显缓解,与治疗前比较术后视觉模拟评分明显下降(P<0.05),2组患者术后临床疗效、满意度、不良反应及复发率比较无统计学差异(P>0.05)。B组术后并发症发生率高于A组(P<0.05)。结论CT引导下经圆孔外口与经卵圆孔行射频热凝治疗上颌神经痛均有确切疗效,但前者患者术后并发症少于后者。

ObjectiveTo observe and compare the clinical effects of CT guided puncturing through foramen rotundum and oval foramen for radio-frequency thermocoagulation to treat primary trigeminal maxillary neuralgia.MethodsTotally 60 patients suffered from maxillary neuralgia duringOctober 2012 to June 2013 were enrolled in this study. By order of admission,single number patients were set as group A and double number pa-tients were set as group B. Group A received lateral entry of foramen rotundum outside the mouth for radiofrequency thermocoagulation of maxillarynerve. Group B received Hartel anterior foramen ovale puncture to gasserian ganglion for radiofrequency thermocoagulation. All patients consentedand signed the informed consent form. The clinical effects and complications at six months after operation were observed and the interim efficacy andthe recurrence rate were followed up.ResultsThe 60 patients got pain free or relieved and their visual analogue scores decreased significantly afteroperation（P〈0.05）. There was no significant difference in clinical efficacy,patient satisfaction,adverse reactions and reoccurrence between thetwo groups（P〉0.05）. The incidence of complications in group B was higher than that in group A（P〈0.05）.ConclusionBoth methods have ex-act curative effects,but the postoperative complications due to CT guided percutaneous puncturing through foramen rotundum are less than those dueto puncturing through oval foramen.