经皮穿刺微球囊压迫术治疗80岁以上老年病人三叉神经痛的疗效分析

LONG-TERM OUTCOME OF PERCUTANEOUS BALLOON COMPRESSION FOR SENIOR PATIENTS WITH TRIGEMINAL NEURALGIA

目的:探讨经皮穿刺微球囊压迫术治疗老年三叉神经痛病人的疗效及安全性。方法:回顾性研究2007年1月至2011年12月期间行经皮穿刺微球囊压迫治疗的80岁以上老年原发性三叉神经痛病人138例,对病人手术即刻疗效、术后中远期疗效和并发症进行总体评价。结果:本组病人术后即刻疼痛治愈率为98.6%(BNIⅠ级、Ⅱ级),在随访过程中第1、2、3、4、5年末的疼痛治愈率分别为93.5%,90.4%,84.7%,80.4%,72.9%。本组病人术后出现复视1例,咀嚼肌无力3例,口唇疱疹19例,下颌骨向健侧移位1例,在疼痛治愈的病人中100%出现面部麻木及面膜不感觉减退。无严重并发症发生。结论:经皮穿刺微球囊压迫术是一种有效且安全的治疗三叉神经痛的方式,可作为身体条件较差的80岁以上老年三叉神经痛病人的首选治疗方式。

Objective： To evaluate the effect and safety of percutaneous balloon compression for trigeminal neuralgia patients older than 80 Years. Methods： One hundred thirty-eight patients aged above 80 years with primary trigeminal neuralgia admitted to Neurosurgery Department of Hangzhou First People＇ s Hospital from January 2007 to December 2011 for percutaneous balloon compression treatment were retrospectively analyzed in this study. The effect and safety of the patients were evaluated. Results： The postoperative cure rate of imme- diate pain was 98.6% （BNI classes I, II）; according to the follow-up, the pain cure rates at l, 2, 3, 4 and 5 years after surgery were 93.5%, 90.4%, 84.7%, 80.4%, 72.9%. Postoperative diplopia was reported in 1 case, masti- catory muscle weakness in 3 cases, and herpes labialis in 19 cases. One hundred percent of pain-cured patients exhibited facial numbness and facial hypoesthesia. No serious complications occurred in this group of patients. Conclusion： Percutaneous balloon compression is an effective and safe procedure for tfigeminal neuralgia treatment and can be suggested as the preferred regimen for TN patients aged above 80 years.