序列化治疗三叉神经痛的临床研究

Clinical research for the serial treatment of trigeminal neuralgia

目的:探讨通过心理疏导、手术、术后持续镇痛序列化治疗三叉神经痛的疗效。方法:我们收集了2008-01~2013-01在黑龙江省医院颌面外科就诊的原发性三叉神经痛患者48例,随机分为治疗组(术前心理疏导后在全麻下行三叉神经周围支撕脱术,术后静脉输注镇痛药物7~14d)及对照组(常规局麻下行三叉神经周围支撕脱术)。对比两组治疗后第6个月、12个月疗效。结果:治疗后6个月,治疗组有效率为95.8%,对照组为54.2%;治疗后12个月,试验组有效率为87.5%,对照组为41.7%;差异具有显著性(P<0.05)。治疗后12个月治疗组疼痛对睡眠、精神状态、日常生活、生活兴趣的干扰评分较对照组低,差异具有显著性(P<0.01)。结论:序列化治疗可以提高治愈率,改善生活质量,可以临床推广。

Objective： To discuss the curative powers of the serial treatment including psychological counse- ling, surgery, and postoperative analgesia. Methods： 48 cases of primary trigeminal neuralgia from January 2008 to January 2013 in Heilongjiang Province Hospital were selected and randomly divided into two groups. Treatment group had done the branch of trigeminal nerve avulsion in general anesthesia after the psychological counseling, and used intravenously postoperative analgesia drug, while the control group had only done nerve avulsion in local anes- thesia. Results： The effective rate of treatment group was 95.8% after 6 months; while the control group was 54.2%. The effective rate in treatment group was 87.5% after 12 months; while the control group was 41.7%. There was a significant difference between two groups （ P 〈 0.05）. The scores of sleeping, mental state, daily life, interest of treatment group were lower than control group （P 〈 0.01 ）. Conclusion： Serial treatment can improve the curative power and the quality of life which can be used for clinical promotion.