显微血管减压术治疗偏头痛

SUPERFICIAL TEMPORAL ARTERY DECOMPRESSION FOR VASCULAR PULSATING MIGRAINE

目的：探讨颞浅动脉切断术治疗血管搏动性偏头痛的临床疗效。方法：总结2007年9月到2014年12月56例临床确诊的典型的颞部血管搏动性偏头痛病例，局麻下实施耳颞神经颞浅动脉切断术，术后部分患者颞浅动脉行H&E染色病理切片观察血管平滑肌变化情况。结果：56例患者实施63次手术，其中7例为双侧颞部的头痛。部分患者颞浅动脉行H&E染色病理切片显示血管平滑肌细胞部分变性增生。术后随访3个月～5年，平均随访49个月。46例偏头痛临床症状消失；4例明显减轻，无需服药治疗，总有效率89.3%；3例于术后3、8、13个月复发（复发率5.3%），行注射治疗后疼痛偶有发作；2例好转，1例无效，均仍需服用镇痛剂对症治疗。结论：颞浅动脉血管平滑肌变性是血管搏动性偏头痛发作的病理基础之一，颞浅动脉切断术是治疗血管搏动性偏头痛的安全有效的方法，疗效可靠。

Objective: To explore the clinical effect of superficial temporal artery decompression for vascular pulsating migraine. Methods: Clinical data of 56 migraine patients treated by superficial temporal artery transection from Sep. 2007 to Dec. 2014 was analyzed retrospectively. Parts of the superficial temporal arteries from patients were sectioned and stained with hematoxylin and eosin. Results: These 56 migraine patients received 63 times of operations because 7 of the patients suffered bilateral migraine. The pathological results showed some of the artery smooth muscle cells becoming deformed and hyperplasia. All the patients were followed up for 3 months to 5 years (mean 49 months). Forty-six patients had pain free, 4 patients’ pain alleviated without medical treatment. The total effective rate was 89.3%. Three patients had recurrence at 3,8,13 months after transection respectively. The recurrence rate was 5.3%. Two patients had pain relief and one didn't.They all need pain-killer to relief the syndrome. Conclusion: Superficial temporal artery smooth muscle cells deformation may be one of the pathological changes of vascular pulsating migraine. Superficial temporal artery transection is a safe and effective method for alleviating vascular pulsating migraine.