老年颅神经病患者行显微血管减压术治疗的疗效和安全性

Safety and efficacy of microvascular decompression in elderly patients with cranial neuropathy

目的探讨老年患者行显微血管减压术(MVD)治疗三叉神经痛(TN)、面肌痉挛(HFS)、舌咽神经痛(GN)等颅神经疾病的安全性及临床效果。方法回顾性分析2015年1月至2017年8月我科收治的72例年龄70岁及以上患者的病例资料,术前均诊断为颅神经病,行MVD治疗,分析患者术后疗效及并发症发生情况。结果72例患者均在全麻下成功接受MVD,术后1年85.7%(30/35)的TN患者面部疼痛症状完全消失或明显改善,94.3%(33/35)的HFS患者的颜面部不自主抽搐症状消失,2例GN患者、4例TN合并HFS患者和1例TN合并GN患者术后临床症状均完全消失。手术过程顺利,术后恢复良好,未出现颅内血肿、梗死、脑脊液漏、急性脑积水和死亡等严重手术并发症。结论老年颅神经病患者术前充分评估后,进行MVD手术安全、有效,并发症少,可明显改善患者生活质量。

Objective To investigate the safety and clinical efficacies of microvascular decompression(MVD)on cranial neuropathy such as trigeminal neuralgia(TN), hemifacial spasm(HFS)and glossopharyngeal neuralgia(GN)in elderly patients. Methods Clinical data of 72 patients aged 70 years and over diagnosed as cranial neuropathy and undergoing microvascular decompression in our department from January 2015 to August 2017 were retrospectively analyzed.The curative effect and complications were analyzed after treatment. Results All patients successfully underwent MVD under general anesthesia.The facial pain completely disappeared or was significantly improved in 85.7%(30/35)of TN patients one year after operation.The intermittent tonic contractions of the facial muscles were completely disappeared in 94.3%(33/35)of HFS patients.Clinical symptoms were completely disappeared in 2 patients with GN, 4 patients with TN and HFS and 1 patients with TN and GN. Conclusions The surgery goes well and the patients have good postoperative recovery, with no severe complications such as intracranial hematoma, infarction, cerebrospinal fluid leakage, acute hydrocephalus and death.After an adequate preoperative evaluation, MVD is safe and effective with a few complications.It can significantly improve the quality of life in elderly patients with trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia.