X线引导下经卵圆孔三叉神经半月节射频热凝术治疗原发性三叉神经痛疗效观察（附368例报道）

Effect of X-ray guided semilunar ganglion radiofrequency thermocoagulation on primary trigeminal neuralgia through oval foramen （368 cases report）

目的评价x线引导下经卵圆孔三叉神经半月节射频热凝术治疗原发性三叉神经痛的疗效和安全性。方法对广州医科大学附属第二医院疼痛科自2011年7月至2014年7月收治的368例原发性三叉神经痛患者进行X线引导下经卵圆孔三叉神经半月节射频热凝术治疗，于术后第3、30、90天采用视觉模拟评分WAs）、睡眠质量评分（QS）、患者满意度评分（PS）评估治疗效果，于术后1、2年随访时或复发人院时统计复发情况。结果与术前WAS、QS、PS评分分别为（8．82±0．84）分、（3．75±0．73）分、（2．90±0．34）分]相比，术后所有患者的疼痛均有明显缓解[术后第3、30、90天VAS评分分别为（1．14±0．91）分、（0．40±0．58）分、（0．18±0．38）分]，睡眠质量改善[术后第3、30、90天QS评分分别为（2．18±0．66）分、（1．37±0．48）分、（1．02±0．15）分]，满意度提高[术后第3、30、90天PS评分分别为（1．35±0．58）分、（1．10±0．30）分、（1．06±0．24）分1；主要并发症包括咀嚼肌力下降67例（7.34％）、角膜感觉减退20例（2．45％）。术后1年内复发率为5．71％，2年内复发率为21．20％，治疗有效时长平均为（22．33±12．70）个月。结论x线引导下经卵圆孔三叉神经半月节射频热凝术治疗原发性三叉神经痛疗效较好，无严重并发症发生，复发率低。

Objective To evaluate the effectiveness and safeness of X-ray guided semilunar ganglion radiofrequency thermocoagulation through oval foramen in the treatment of trigeminal neuralgia. Methods Three hundred and sixty-eight patients with primary trigeminal neuralgia, admitted to our hospital from July 2011 to July 2014, were successfully treated with X-ray guided semilunar ganglion radiofrequency thermocoagulation through oval foramen. Three, 30 and 90 d after treatment, the treatment effectiveness was evaluated. The recurrence rates were calculated one and two years after treatment or to the date of their relapses to hospital. Results All patients showed obvious pain relief, with visual analogue scale scores decreasing from 8.82±0.84 to 1.14±0.91, to 0.40±0.58, and then to 0.18±0.38 on 3rd , 30th and 90th d. Their qualities of sleep were improved： quality of sleep scale scores dropped from 3.75± 0.73 to 2.18±0.66, to 1.37±0.48, and then to 1.02±0.15, respectively. Meanwhile, patient satisfaction was increased： as patient satisfaction scale scores reduced from 2.90±0.34 to 1.35±0.58, to 1.10±0.30, and then to 1.06±0.24, respectively. The main complications were masticatory muscle weakness in 67 patients （7.34%）, and corneal hypesthesia in 20 patients （2.45%）. Postoperative recurrence rate was 5.71% in one year, and 21.20% in two years. The mean time of effective therapeutic duration was 22.33±12.70 months. Conclusions X-ray guided semilunar ganglion radiofrequency thermocoagulation through oval foramen is effective and safe for the treatment of primary trigeminal neuralgia, enjoying no severe complications and low recurrence rate.