三叉神经痛显微血管减压术的手术技巧及疗效分析

Effect of Microvascular Decompression on Trigeminal Neuralgia and the Surgical Technique

目的探讨显微血管减压术的手术技巧及手术疗效。方法回顾性分析2008年1月～2017年1月手术治疗228例原发性三叉神经痛患者的临床资料,对手术操作步骤、疼痛缓解程度和术后并发症进行分析。结果术后第7天,症状完全消失201例(88.2%),明显缓解9例(3.9%),部分缓解8例(3.5%),无效和死亡10例(4.4%),主要并发症有听力障碍15例(6.6%)、面部麻木17例(7.5%),其它严重并发症有颅内感染3例(1.3%)、颅内出血6例(2.6%)、死亡2例(0.9%)。结论显微血管减压术是治疗三叉神经痛安全有效的方法。不断提高显微外科操作技巧及规范操作有利于提高手术疗效,减少术后并发症的发生。

Objective To discuss the effect of microvascular decompression(MVD)on trigeminal neuralgia and the surgical technique.Methods A retrospective analysis was made to the clinical data of 228 cases with primary trigeminal neuralgia undergoing surgery;the surgical procedure,pain relief and post-operative complication occurrence were analyzed.Results At the 7th day after MVD,symptom disappearance was found in 201 cases(88.2%),obvious symptom relief in 9 cases(3.9%),partial symptom relief in 8 cases(3.5%),ineffectiveness and death in 10 cases(4.4%);the main complications included hearing deficit in 15 cases(6.6%),facial numbness in 17 cases(7.5%),and the severe complications were intracranial infection in 3 cases(1.3%),intracranial hemorrhage in 6 cases(2.6%)and death in 2 cases(0.9%).Conclusions MVD is safe and effective in the treatment of trigeminal neuralgia,and it is of help in increasing the effect and decreasing the occurrence of post-operative complications to raise the surgical technique and to standardize the operation procedure.