CT引导下射频复合阿霉素介入治疗三叉神经痛的临床观察

Therapeutic effects of CT-guided radiofrequency thermocoagulation and doxorubicin on trigeminal neuralgia

目的研究CT引导下阿霉素复合热凝射频对三叉神经痛的临床疗效及安全性。方法三叉神经痛患者60例,随机分为A组和B组,每组30例。在CT引导下,所有患者行半月神经节穿刺,A组患者给予阿霉素治疗,B组给予热凝射频+阿霉素治疗。比较2组患者起效时间,治疗前、治疗后1周、1个月、2个月、4个月和8个月的疗效评分、视觉模拟评分(VAS)和睡眠评分,同时观察患者术后不良反应。结果 B组起效时间明显短于A组(P<0.05),治疗后1周、2个月、4个月和8个月的优良率明显高于A组(P<0.05)。B组治疗后1周、2个月、4个月和8个月VAS评分明显低于A组,治疗后2个月、4个月和8个月的睡眠评分明显高于A组(P<0.05)。B组麻木发生率高于A组(P<0.05),其他不良反应相比差异无统计学意义(P>0.05)。结论 CT引导下热凝射频复合阿霉素治疗三叉神经具有起效快,疗效长的优点,值得临床推广。

Objective To investigate the therapeutic effects and safety of CT-guided radiofrequency thermocoagulation and doxorubicin on trigeminal neuralgia. Methods Sixty patients with trigeminal neuralgia were randomly divided into group A and group B,with 30 patients in each group. The patients in both groups were punctured percutaneously in semilunar ganglion according to CT scanning. The patients in group A were treated by doxorubicin,however,the patients in group B were treated by radiofrequency thermocoagulation ＋ doxorubicin. The starting time of therapeutic effects,curative effect score,visual analogue scale（ VAS）,sleep quality score before treatment and at 1 week,1 month,2 months,4 months and 8 months after treatment were observed and compared between two groups,moreover,the adverse reactions after treatment were observed in both groups. Results The starting time of therapeutic effects in group B was significantly shorter than that in group A. The excellent rates of therapeutic effects at 1week,2 months,4 months and 8 months after treatment in group B were significantly higher than those in group A. After treatment the VAS scores in group B in the five time points were significantly lower than those in group A,however,the sleep quality scores in group B at 2 months,4 months and 8 months after treatment were significantly higher than those in group A（ P 〈0. 05）. The incidence of numbness in therapy area of group B was significantly higher than that in group A（ P 〈0. 05）. Moreover there were no significant differences in the other adverse reactions between two groups（ P 〈0. 05）. Conclusion CT-guided radiofrequency thermocoagulation combined with doxorubicin has the advantages of fast efficiency and long- term curative effects in treatment of trigeminal neuralgia.