CT引导下经皮圆孔穿刺射频温控热凝术治疗三叉神经痛(第Ⅱ支)的疗效及安全性

Efficacy and safety of CT-guided percutaneous radiofrequency thermocoagulation through foramen rotundum in treatment of V2 trigeminal neuralgia

目的 探讨薄层CT引导下经皮穿刺圆孔射频热凝术治疗药物无效或复发性三叉神经痛（第Ⅱ支）的疗效及安全性。方法 对药物无效或复发性三叉神经痛（第Ⅱ支）的22例患者行CT引导下经皮穿刺圆孔射频热凝术治疗，采用巴罗神经学研究所（BNI）分级评定标准评价患者术后疗效，观察术后并发症情况。结果 22例患者术后即刻疼痛完全缓解率达95.45%（21/22），1例患者术后疼痛有所缓解，但服药后可以控制（BNI分级Ⅲ级）。2例患者术后复发，均再次行射频术，术后即刻疼痛均完全缓解（BNI分级Ⅰ级）。随访3~19个月，平均（7.73±4.69）个月。所有患者均无任何严重并发症发生。结论 薄层CT引导下经皮穿刺圆孔射频热凝治疗药物无效或复发性三叉神经痛（第Ⅱ支）的疗效可靠、并发症少，可作为药物无效或复发性三叉神经痛的一种理想微创治疗手段。

Objective To investigate the efficacy and safety of CT-guided percutaneous radiofrequency thermocoagulation through foramen rotundum in the treatment of drug-resistant or recurrent V2 trigeminal neuralgia. Methods A total of 22 cases of V2 trigeminal neuralgia patients were included. All patients underwent CT-guided percutaneous radiofrequency thermocoagulation through foramen rotundum. Barrow Neurological Institute （BMI） classification criteria was used to evaluate the efficacy, and the postoperative complications were observed. Results The initial total pain relief rate was 95.45% （21/22）, and 1 patient had some pain but could be adequately controlled with medication （BNI scale Ⅲ）. Two patients was recurrent, who received the same procedure again and had total pain relief initially （BNI scale Ⅰ）. All patients were followed up for 3 to 19 months, the average was （7.73±4.69） months. No serious complications occured. Conclusion CT-guided percutaneous radiofrequency thermocoagulation through foramen rotundum is a good choice for the treatment of drug-resistant or recurrent V2 trigeminal neuralgia, which has reliable efficacy and fewer complications.