较低温度局麻下射频热凝术治疗三叉神经痛的有效性分析

Analysis of Effectiveness of Radiofrequency Thermocoagulation Surgery under the Low Temperature Local Anesthesia in Treatment of Prosopalgia

目的探究较低温度局麻下射频热凝术治疗三叉神经痛的有效性。方法选取该院疼痛科收治的原发性三叉神经痛患者作为研究样本,从中随机选取病例数120例进行研究。该次研究的时间范围为2014年1月—2015年3月,所有患者在CT引导下行局麻射频热凝术进行治疗,根据温度不同将120例患者分为3组。其中第一组温度设为65℃、第二组设为70℃、第三组设为75℃,对比3组患者术后疼痛率、并发症发生率、术后3年复发率以及生活质量评分。结果 120例患者的手术均顺利完成,第二组和第三组患者术后疼痛缓解率相差不大:均为10.00%,并优于第一组疼痛缓解率(15.00%),组间对比差异无统计学意义(P>0.05);在并发症发生率和复发率对比中,第一组患者的最低(复发率7.50%、并发症5.00%),第二组略高于第一组(第二组复发率15.00%、并发症发生率20.00%),而第三组最高(复发率、并发症发生率均为25.00%),患者的康复时间最长,组间对比差异有统计学意义(P<0.05)。在生活质量方面,第二组患者的生活质量总分高于其他两组,而第一组次之,第三组最后,对比3组数据均差异有统计学意义(P<0.05)。结论 65℃、75℃下行射频热凝术能够有效改善患者的疼痛,但是患者的并发症发生率与温度呈正相关。而且在70℃和75℃复发率相差并不大,75℃治疗的患者康复效果不佳,不建议采用高温度的射频热凝术治疗三叉神经痛,建议选择65℃进行治疗。

Objective To study the effectiveness of radiofrequency thermocoagulation surgery under the low temperatur under local anesthesia in treatment of prosopalgia. Methods 120 cases of patients with primary prosopalgia admitted and treated in our hospital from January 2014 to March 2015 were selected and treated with CTG-guided radiofrequency thermocoagulation surgery under the local anesthesia, and 120 cases of patients were divided into three groups according to different temperatures, 65℃ in the first group, 70℃ in the second group and 75℃ in the third group, and the postoperative pains rate, incidence rate of complications, recurrence rate in 3 years after surgery and quality of life scores were compared between the three groups. Results 120 cases of patients had successfully finished the surgery,and the difference in the postoperative pains relief rate between the second group and the third group was not big,10.00%, which was better than that in the first group 15.00%, and the difference between groups was not statistically significant（P〈0.05）, and the incidence rate of complications and recurrence rate in the first group were the lowest, and the indexes in the second group were slightly higher than those in the first group, while the indexes in the third group were the highest, and the indexes in the first, second and third groups were respectively 7.50%, 5.00%; 15.00%,25.00%; 25.00%, 25.00%）, and the rehabilitation time of patients was the longest the difference between groups was not statistically significant（P〈0.05）, and the total score of quality of life in the second group was higher than that in the other two groups, but the index in the first group was second, and the index in the third group was the last, and the differences between groups were obvious, with statistical significance（P〈0.05）. Conclusion The radiofrequency thermocoagulation surgery under 65℃, 75℃ can effectively improve the pains of patients, but the incidence rate of complications is positively correlated with the temperature, and the difference in the recurrence rate between 70℃ and 75℃ is not big, and the rehabilitation effect of patients under 75℃ is not good, and it is not suggested to use radiofrequency thermocoagulation surgery under the low temperatur under local anesthesia in treatment of prosopalgia, but 65℃ can be suggested.