CT引导下圆孔入路穿刺射频治疗三叉神经上颌支痛

CT-guided radiofrequency to treat V2 trigeminal neuralgia through foramen rotundum puncture

目的 探讨CT引导下经圆孔入路治疗三叉神经上颌支痛的临床疗效与安全性.方法 拟行CT引导下经皮穿刺射频热凝术的原发性三叉神经上颌支痛患者,30例采用经圆孔入路穿刺射频（A组）,30例采用传统Hartel入路（B组）.记录手术时间、穿刺微调次数、手术并发症发生率、术前术后视觉模拟评级法（VAS）评分及评估术后1、24个月的临床疗效.结果 两组术前VAS评分[（7.9±1.2）分比（8.1±1.4）分]、术后VAS评分[（0.7±0.4）分比（0.8±0.2）分]、1个月临床疗效（80.0％比83.3％）、12个月临床疗效（76.7％比80.0％）比较差异无统计学意义（P＞0.05）;与B组比较,A组手术时间短[（33.2±8.1）min比（43.9 ±21.6） min],穿刺微调次数少[（1.1±0.4）次比（4.4±1.5）次],头痛（3.3％比20.0％）、咀嚼肌无力（0.0％比36.7％）、舌体麻木（0.0％比50.0％）等并发症发生率低（P＜0.05）.结论 CT引导下圆孔入路穿刺射频治疗三叉神经上颌支痛具有操作简便、快捷,临床疗效好、并发症少的优点.

Objective To study the clinical efficacy and safety of CT-guided radiofrequency to treat V2 trigeminal neuralgia through foramen rotundum puncture.Methods Sixty patients undergoing CT-guided percutaneous radiofrequency for V2 trigeminal neuralgia were divided into two groups （n =30 each）.Thirty cases were treated by radiofrequency thermocoagulation through the foramen rotundum approach （group A）,and 30 cases through oval foramen approach （group B）.The operative time,times of the procedure,complications,the visual analogue scale （VAS） scores before and after treatment,and the clinical efficacy were recorded.Results The VAS scores and clinical efficacy showed no significant difference between two groups,P＞0.05.Operative time was shorter [（33.2 ± 8.1） min vs.（43.9 ± 21.6） min],times of the procedure were less [（1.1 ± 0.4） vs.（4.4 ± 1.5）],and the complications were less,such as headache （3.3％ vs.20.0％）,masticatory weakness （0.0％ vs.36.7％）,tongue numbness （0.0％ vs.50.0％）,in group A than in group G,P ＜0.05.Conclusion There are some advantages with CT-guided radiofrequency to treat V2 trigeminal neuralgia through foramen rotundum puncture,such as simple operation,satisfactory clinical efficacy and less complications.