微血管减压术(MVD)与微球囊压迫术(PMC)治疗原发性三叉神经痛的疗效比较

Comparison of Curative Effect Between Microvascular Decompression(MVD) and Percutaneous Microballoon Compression( PMC) in Treatment of Primary Trigeminal Neuralgia

目的探讨微血管减压术(Microvascular Decompression,MVD)与微球囊压迫术(Percutaneous Microballoon Compression,PMC)治疗原发性三叉神经痛的疗效比较。方法调查并收集我院神经外科行MVD与PMC对原发性三叉神经痛患者治疗情况,从术前评估、术后有效率、复发率及并发症等多个方面评价两种治疗方案。结果两种治疗方法均有效,疗效及术后复发率无显著差异。MVD组17例患者中,4例出现口角单纯疱疹,2例出现暂时性感觉减退,1例出现暂时性耳聋耳鸣。PMC组中全部出现暂时性感觉减退,10例出现咀嚼肌无力,1例面部麻木"蚁走感"。结论对于年轻、身体状态佳、术前辅助检查有明确血管压迫的患者,主张首选微血管减压术(MVD)治疗。对于高龄、一般状态差、不耐受或拒绝接受开颅手术者,主张选择经皮穿刺微球囊压迫(PMC)治疗。安全有效且微创,短期之内可以重复实施,从而降低了医疗费用及住院时间。

Objective To compare the curative effect of microvascular decompression （ MVD ） and percutaneous microballoon compression （PMC） in the treatment of primary trigeminal neuralgia. Methods The patients with primary trigeminal neuralgia who were treated with MVD or PMC in our hospital were collected and investigated. The two methods were compared in the terns of the pre- operative assessment, the effective rate, recurrence rate and complications after operation. Results Both methods were effective, and had no significant difference in the effective rate and recurrence rate. Among the 17 patients in the MVD group, 4 had herpes sim- plex, 2 suffered from temporary hypoesthesia, and 1 experienced temporary deafness and tinnitus. In the PMC group, all the patients were found with temporary hypoesthesia, 10 with masticatory atonia, and 1 with formication in the face. Conclusion For young pa- tients in good condition with clear vascular compression in preoperative check, MVD is preferred. For the elders in poor condition who were intolerant or rejeetive of Craniotomy, PMC is a good choice, because it is a minimal invasive therapy, safe and effective, and can be repeated during short period, which can reduce medical costs and length of hospital stay.