显微血管减压治疗脑神经疾病的疗效观察

Microvascular decompression for the treatment of cerebral neuropathy

目的总结显微血管减压术(MVD)治疗原发性脑神经疾病的手术技巧及疗效。方法选取昆明医科大学第一附属医院微创神经外科自2010年4月至2018年12月采用MVD治疗的832例脑神经疾病患者进行回顾性分析,其中三叉神经痛489例、面肌痉挛338例、舌咽神经痛患者5例,观察其疗效,统计并发症发生率。结果所有病例随访时间为3~84个月,平均32.5个月,本组无死亡病例及其他严重并发症发生,三叉神经痛患者手术治愈率为98.36%,面肌痉挛手术治愈率为97.93%,舌咽神经痛治愈率为100.00%。结论MVD是治疗原发性脑神经疾病的可靠方法,熟练的显微外科技术和丰富的手术经验及对于解剖的熟悉程度是手术治疗脑神经疾病的基础。

Objective To explore the application and technique of microvascular decompression(MVD)in the treatment of cerebral neuropathy.Methods Totals of 832 cases of primary cranial neuropathy under MVD treatment from April 2010 to December 2018 were retrospectively analyzed,which included 489 trigeminal neuralgia cases,338 hemifacial spasm cases and 5 glossopharyngeal neuralgia cases.The surgical techniques and prevention of postoperative complications were analyzed.Results The follow-up time ranged from 3 to 84 months(mean 32.5 months).There was no death or other severe complications in our group.The postoperative cure rate with trigeminal neuralgia was 98.36%,97.93%with hemifacial spasm and 100.00%with glossopharyngeal neuralgia.Conclusion MVD is a reliable method for primary cranial neuropathy,what is more,skilled microsurgical techniques,rich microsurgical experience and familiarity with the anatomy are the foundation of the surgical treatment for cranial neuropathy.