微血管减压术治疗原发性典型与不典型三叉神经痛对比研究

The comparative research of primary typical and atypical trigeminal neuralgia treated bg microvascular decompression

目的探讨原发性典型与不典型三叉神经痛微血管减压术治疗的临床效果。方法选择原发性典型与不典型三叉神经痛患者各40例,在全身麻醉气管插管下完成微血管减压术,比较2组术中所见血管压迫来源、压迫程度及血管压迫位置。结果典型三叉神经痛组压迫血管来源为单纯动脉占85.0%,显著高于非典型三叉神经痛组的57.5%(P<0.05);来源为动静脉混合占15.0%,显著低于非典型三叉神经痛组的42.5%(P<0.05);典型三叉神经痛组血管与神经位置接触者显著高于非典型三叉神经痛者(P<0.05),术中发生三叉神经出现萎缩者比例显著少于非典型三叉神经痛者(P<0.05),典型三叉神经痛者其压迫血管在近端者显著多于非典型三叉神经痛者(P<0.05),压迫血管在远端者显著少于非典型三叉神经痛者(P<0.05)。结论原发性三叉神经痛实施血管减压术,术前鉴定其发病特点,在预测其压迫血管类型、位置及其与神经的关系具有一定临床价值。

Objective To investigate the effect of microvascular decompression on treating primary typical and atypical trigeminal neuralgia.Methods 40 cases with primary typical and 40 cases with atypical trigeminal neuralgia were chosen,all of which were completed microvascular decompression under general anesthesia and endotracheal intubation.The origin of compressed blood vessels,the degree and position of compression were compared in two groups.Results Compressed blood vessels originated from simple artery in typical group accounted for 85.0%,which was significantly higher than 57.5% of atypical group（P〈0.05）;and originated from mixed arteriovenous accounted for 15.0%,which was significantly lower than 42.5% of the atypical group（P〈0.05）.The number of nerve and vessel rather closing together and compression in vascular proximity of typical group were significantly higher than that of atypical group in operation（P〈0.05）,and the number of atrophy of trigeminal nerve and compression in vascular distance of typical group were significantly less than that of atypical trigeminal neuralgia（P〈0.05）.Conclusion Trigeminal neuralgia treated with microvascular decompression and characteristics identified before operation can predict vascular compression type,position and its relationship with nerves.