微血管减压术治疗三叉神经痛的效果及血管受压程度对疗效的影响

Therapeutic effect of microvascular decompression on trigeminal neuralgia and the influence of vascular compression on the therapeutic effect

目的 探讨微血管减压术治疗三叉神经痛（TN）的临床效果,并分析血管受压程度对临床疗效及预后的影响.方法 选取2016年4月至2017年5月在临汾市中心医院治疗的72例TN患者分为对照组（常规手术治疗,n=36）和研究组（微血管减压术治疗,n=36）,回顾分析两组患者的临床疗效及预后情况.根据术中受压程度将72例患者分为轻度受压组和中重度受压组,比较两组患者的临床疗效及复发情况.结果 研究组治疗后疼痛视觉模拟评分（VAS）低于对照组;并发症发生率为13.9％,低于对照组的36.1％（t=6.656,χ^2=4.740,P〈0.05）.研究组治疗后生活质量评价量表（SF-36）4个维度评分均高于对照组（P均〈0.05）.研究组总有效率（94.44％）高于对照组（80.00％）,复发率（16.7％）低于对照组（30.5％）,差异有统计学意义（χ^2=4.180、3.895,P〈0.05）.中重度受压组治疗总有效率（63.6％）低于轻度受压组（98.0％）,复发率（68.2％）高于轻度受压组（4.0％）,差异有统计学意义（χ^2=16.394、34.892,P〈0.05）.结论 给予TN患者微血管减压术治疗可取得更理想的效果,血管受压程度越严重,治疗效果越差.

Objective To investigate the clinical effects of microvascular decompression on trigeminal neuralgia （ TN） , and influence of vascular compression on the clinical efficacy and prognosis . Methods Seventy-two TN patients who were treated in Linfen Central Hospital from April 2016 to May 2017 were selected and were divided into control group （routine surgical treatment , 36 cases） and study group （microvascular decompression , 36 cases）.The clinical efficacy and prognosis of the two groups were retrospectively analyzed .According to the degree of intraoperative pressure , 72 patients were divided into mild compression group and moderate to severe compression group , the clinical efficacy and recurrence of two groups were compared .Results The postoperative visual analogue scale （ VAS） score of study group was lower than that of control group;the incidence of complications was 13.9%in study group, less than 36.1%in control group （t=6.656,χ^2 =4.740, P〈0.05）.The 4 dimensions of the short form 36 questionnaire （ SF-36） score in study group were higher than those in control group （ P all〈0.05 ） .The total effective rate of study group （ 94.44%） was higher than that of control group （80.00%）, the recurrence rate （16.7%） of study group was lower than that of control group （30.5%,χ^2 =4.180, 3.895, P〈0.05 ）.The total effective rate of moderate to severe compression group （63.6%） was lower than that of mild compression group （98.0%） , the recurrence rate in moderate to severe compression group （ 68.2%） was higher than that in mild compression group （ 4.0%, χ^2 =16.394, 34.892,P〈0.05）.Conclusions Microvascular decompression is a better treatment for TN patients, the more severe vascular compression degree and the treatment effect is poorer .