微血管减压术治疗原发性三叉神经痛88例临床分析

Microvascular decompression for the treatment of idiopathic trigeminal neuralgia: a clinical analysis of 88 cases

目的：探讨微血管减压术（ MVD）治疗原发性三叉神经痛的疗效。方法回顾该科微血管减压术治疗88例原发性三叉神经痛患者的临床资料，结合术中所见、手术疗效及并发症进行临床分析。结果88例患者术中发现有责任血管压迫84例，无血管压迫而仅见蛛网膜粘连4例。术后疼痛完全消失80例，疼痛减轻7例，无效1例。随访6个月～5年未见一例复发。术后并发症发生恶心、呕吐及眩晕8例，面部感觉麻木8例，面瘫3例，听力下降2例，切口愈合不良1例，皮下积液5例，脑脊液耳漏1例。无死亡及致残患者。结论微血管减压术治疗原发性三叉神经痛安全有效。

Objective To investigate the clinical outcomes of microvascular decompression（MVD） for the treatment of idiopathic trigeminal neuralgia.Methods The clinical data, including intra-operative findings, treat-ment outcomes and complications of 88 idiopathic trigeminal neuralgia patients treated with MVD were retrospectively analyzed.Results Among the 88 cases undergoing MVD, vascular compression was observed in 84 and arachnoid adhesion without vascular compression in 4.After the operation, pain was disappeared in 80, relieved in 7, and not relieved in 1.No recurrence was found after a follow-up of 6 to 60 months.The postoperative complications included 8 cases of nausea, vomiting and dizziness, 8 facial numbness, 3 facial paralysis, 2 hearing loss, 1 poor incision heal-ing, 5 subcutaneous hydrops and 1 cerebrospinal fluid otorrhea.No death or disability occurred.Conclusion MVD is a safe and effective surgical method for the treatment of idiopathic trigeminal neuralgia.