微血管减压术治疗舌咽神经痛17例临床分析

CLINICAL EFFECT OF MICROVASCULAR DECOMPRESSION FOR GLOSSOPHARYNGEAL NEURALGIA:AN ANALYSIS OF 17 CASES

目的探讨微血管减压术治疗舌咽神经痛的效果。方法回顾性分析我院2012年1月-2019年6月经微血管减压术治疗的17例舌咽神经痛患者临床资料,包括一般资料、手术疗效及相关并发症等。结果术后第1天患者根据巴罗神经疾病研究所(BNI)疼痛强度分级:Ⅰ级10例(58.8%),Ⅱ级7例(41.2%),与治疗前比较,差异有统计学意义(Z=-5.169,P<0.05)。经过6月~7年随访,患者的BNI疼痛强度分级:Ⅰ级11例(64.7%),Ⅱ级3例(17.6%),Ⅲ级2例(11.8%),Ⅴ级1例(5.9%),与治疗前相比较,差异具有统计学意义(Z=-4.785,P<0.05);与术后第1天比较,差异无统计学意义(P>0.05)。4例(23.5%)患者术后早期出现并发症,分别表现为声音嘶哑、吞咽困难、饮水呛咳、面瘫及面部麻木;1例(5.9%)患者出现迟发性的咽部不适。结论微血管减压术是治疗舌咽神经痛安全、有效的方法,值得在临床上推广应用。

Objective To explore the clinical effect of microvascular decompression in the treatment of glossopharyngeal neuralgia.Methods A retrospective analysis was performed on the clinical data of 17 patients with glossopharyngeal neuralgia who were treated by microvascular decompression in Affiliated Hospital of Qingdao University from January 2012 to June 2019,including general information,surgical outcome,and related complications.Results On the first postoperative day,the patients were classified as gradeⅠin 10 cases(58.8%)and gradeⅡin 7 cases(41.2%)according to Barrow Neurological Institute(BNI)Pain Intensity Score,showing significant changes compared with the BNI grades before treatment(Z=-5.169,P<0.05).After 6 months to 7 years of follow-up,the patients were classified as BNI I in 11 cases(64.7%),BNIⅡin 3 cases(17.6%),BNIⅢin 2 cases(11.8%),and BNIⅤin 1 case(5.9%),showing significant changes compared with the BNI grades before treatment(Z=-4.785,P<0.05),but no significant changes compared with the BNI grades on the first postoperative day(P>0.05).Four patients(23.5%)experienced early postoperative complications,including hoarseness,dysphagia,drinking cough,facial paralysis,and facial numbness;1 patient(5.9%)had delayed pharyngeal discomfort.Conclusion Microvascular decompression is a safe and effective treatment for glossopharyngeal neuralgia and holds promise for clinical application.