CT引导下蝶腭神经节低温等离子射频消融治疗蝶腭神经痛的临床研究

Clinical study of CT-guided sphenopalatine ganglion low temperature plasma radiofrequency ablation for sphenopalatine neuralgia

目的探讨CT引导下蝶腭神经节低温等离子射频消融术治疗蝶腭神经痛的有效性和安全性。方法选择2015年1月~2016年8月在宣武医院疼痛科接受蝶腭神经节低温等离子射频消融术治疗的原发性蝶腭神经痛患者61例,对其术前及术后1 d、3 d、1周、1个月、3个月、半年、1年、2年的视觉疼痛模拟评分(VAS)进行比较,采集术后1周和术后1年患者的主观满意度(MacNab)评分,同时观察患者术后麻木及并发症的发生情况。结果患者术后各时点的VAS评分较术前均显著降低(P<0.05)。术后1周和术后1年的MacNab评分比较,差异无统计学意义(P>0.05);术后1周和术后1年的优良率分别为91.8%和83.6%。术后1周面部轻度麻木的发生率为31.1%,术后1年无一例麻木患者。所有患者均无严重手术并发症发生。结论 CT引导下蝶腭神经节低温等离子射频消融术治疗原发性蝶腭神经痛,患者可获得满意的临床疗效,不良反应轻微,值得在临床推广。

Objective To investigate the efficacy and safety of CT-guided sphenopalatine ganglion plasma radiofrequency ablation for the treatment of sphenopalatine neuralgia(SPN). Methods From January 2015 to August 2016, 61 patients with SPN treated with CT-guided sphenopalatine ganglion low temperature plasma radiofrequency ablation in the Department of Pain Management of Xuanwu Hospital, Capital Medical University were selected, the VAS scores of patients were compared at before and 1 d, 3 d, 1 week, 1 month, 3 months, 6 months, 1 year and 2 years after the surgery. The Mac Nab scores were observed at 1 week and 1 year after the surgery. The postoperative facial numbness and complications of patients were also recorded. Results The VAS scores of patients at each time point after surgery were significantly lower than those before surgery(P < 0.05). There was no significant difference in Mac Nab scores 1 week and1 year after surgery(P > 0.05), and the excellent and good rates 1 week and 1 year after surgery were 91.8% and83.6% respectively. The incidence of mild postoperative facial numbness was 31.1% at 1 week after the surgery, there was no postoperative facial numbness patients 1 year after the surgery. All patients had no serious surgical complication. Conclusion Patients with SPN can obtain satisfactory clinical results and mild adverse reactions after the sphenopalatine ganglion plasma radiofrequency ablation, it is worthy of clinical promotion.