显微血管减压治疗三叉神经痛和面肌痉挛的临床分析

Clinical analysis on microvascular decompression in treatment of trigeminal neuralgia and hemifacial spasm

目的总结显微血管减压术治疗三叉神经痛和面肌痉挛的手术体会,分析疗效和术后并发症。方法回顾性分析2011年4月至2018年6月20例行显微血管减压术治疗的三叉神经痛和面肌痉挛患者的临床资料。从骨窗显露与神经血管保护、责任血管辨识与手术策略、疗效及术后并发症等方面进行总结分析。结果本组病例手术早期的总体治愈率为95%,其中三叉神经痛患者术后治愈8例,面肌痉挛患者术后即刻治愈10例,延迟痊愈1例,好转1例,严重并发症1例,轻度并发症3例。手术策略和技巧与疗效及并发症相关。结论显微血管减压术是治疗三叉神经痛及面肌痉挛的有效外科方法,个体化选择不同的手术策略对疗效和并发症的发生具有重要意义。

Objective To summarize the surgical experience of microvascular decompression （MVD） for trigeminal neuralgia （TN） and hemifacial spasm （HFS） and investigate the efficacy and complications. Methods 20 patients with TN and HFS treated with MVD from April 2011 to June 2018 were respectively analyzed and evaluated from the following perspectives ：craniotomy, protection of nerves and vessels, identification of the compressing vessels, surgical strategy, curative effect and complications. Results The early total cure rate was 95%. 8 cases of TN were cured. 10 cases of HFS were healed instantly. 1 HFS was delayed healed. 1 HFS was delayed improved. 1 patient had severe complications. 3 patients had mild complications. Surgical strategy con＇elated with curative effect and complications. Conclusion MVD is an effective treatment for the patients with TN and HFS, individualized surgical strategy is significant to the efficacy and complications.