微血管减压术与伽玛刀治疗原发性三叉神经痛的效果比较

Effect comparison between microvascular decompression and Gamma Knife surgery in the treatment of primary trigeminal neuralgia

目的比较微血管减压术与伽玛刀治疗原发性三叉神经痛的效果。方法选取2010年1月~2013年12月本院收治的82例原发性三叉神经痛患者作为研究对象,按照治疗情况分为微血管减压术组（40例）和伽玛刀组（42例）。比较两组的疼痛程度及治疗效果。结果微血管减压术组的治愈率显著高于伽玛刀组,差异有统计学意义（P〈0.05）。两组的缓解率比较,差异无统计学意义（P〉0.05）。两组治疗后1、3个月的疼痛情况比较,差异无统计学意义（P〉0.05）。微血管减压术组治疗后6、9、12个月的疼痛评分显著低于伽马刀组,差异有统计学意义（P〈0.05）。两组的并发症发生率比较,差异无统计学意义（P〉0.05）。结论微血管减压术的疗效优于伽玛刀治疗,且比伽玛刀治疗术后止痛效果更佳,患者满意度更高,可作为年轻患者治疗的首选方法,但是,对于基础情况差的高龄患者、不能耐受微血管减压手术或全麻的患者或并发症状严重的其他患者,伽玛刀治疗仍是较好的姑息治疗方式。

Objective To compare the effect between microvascular decompression and Gamma Knife surgery in the treatment of primary trigeminal neuralgia. Methods 82 primary trigeminal neuralgia patients from January 2010 to December 2013 in our hospital were selected and divided into the microvascular decompression group（40 cases） and the Gamma Knife group（42 cases） according to condition of treatment.The pain degree and the treatment effect in two groups was compared. Results The cure rate of the microvascular decompression group was higher than that of the Gamma Knife group,with significant difference（P 0.05）.There was no significant difference of ease rate between the microvascular decompression group and the Gamma Knife group（P0.05）.There was no significant difference of pain situation after 1 month and 3 months between the microvascular decompression group and the Gamma Knife group（P0.05）.The score of pain in the microvascular decompression group after treatment in 6,9,12 months was lower than that in the Gamma Knife group,with significant difference（P0.05）.There was no significant difference in the incidence rate of complication between the microvascular decompression group and the Gamma Knife group（P0.05）. Conclusion The effectiveness of microvascular decompression is superior than Gamma Knife,and which is better than the gamma knife for the treatment of postoperative pain,the satisfaction degrees is higher,can used as young patients treatment of preferred method,but for elderly patients with poor foundation,patients with severe vascular decompression surgery or general anesthesia,other patients with complicated with severe symptoms,Gamma Knife treatment is still a good palliative treatment.