两种微创手术方案对复发性三叉神经痛患者疗效及安全性的影响

The influence of two kinds of minimally invasive surgical procedures on the clinical efficacy and safety of patients with recurrent trigeminal neuralgia

目的探讨MVD和PBC手术对复发性三叉神经痛患者疗效及安全性的影响。方法选取2016年2月-2018年2月收治复发性三叉神经痛患者共110例,以随机数字表法分为A组(55例)和B组(55例),分别采用MVD和PBC手术治疗,比较2组手术时间、住院时间、临床疗效、复发率及术后并发症发生率。结果 B组手术时间和住院时间均显著少于A组(P<0.05);B组治疗痊愈率显著低于A组(P<0.05);2组治疗有效率比较无显著性差异(P>0.05);B组术后复发率显著高于A组(P<0.05);B组术后三叉神经抑制反应和面部麻木发生率均显著高于A组(P<0.05);2组口角疱疹发生率比较无显著性差异(P>0.05)。结论 MVD手术治疗复发性三叉神经痛可有效提高总体疗效,降低术后复发风险,并有助于预防相关术后并发症发生,而PBC手术治疗则具有医源性创伤小、操作难度低及术后恢复快等优势。

Objective To investigate the influence of MVD and PBC on the clinical efficacy and safety of patients with recurrent trigeminal neuralgia.Methods 110 patients with recurrent trigeminal neuralgia were chosen from February 2016 to February 2018 and randomly divided into 2 groups including A group(55 patients) with MVD and B group(55 patients) with PBC,and the operation time, hospitalization time, clinical efficacy, recurrence rate and postoperative complication rate of both groups were compared.Results The operation time and hospitalization time of B group were significantly less than those of A group(P<0.05). The clinical cure rate of B group was significantly lower than that of A group(P<0.05). There was no significant difference in the clinical effective rate between 2 groups(P>0.05). The recurrence rate of B group was significantly higher than that of A group(P<0.05). The incidence of trigeminal nerve suppression and facial numbness after operation of B group were significantly higher than those of A group(P<0.05). There was no significant difference in the incidence of herpes zoster between 2 groups(P>0.05).Conclusion MVD in the treatment of patients with recurrent trigeminal neuralgia could efficiently increase overall clinical efficacy, reduce postoperative recurrence risk and be helpful to prevent postoperative complications, but PBC application should possess the advantages including less Iatrogenic trauma, lower operation difficulty and more quickly postoperative recovery process.