三叉神经微血管减压术治疗老年人三叉神经痛的疗效观察

Observation on the curative effect of trigeminal nerve microvascular decompression in the treatment of elderly trigeminal neuralgia

目的观察三叉神经微血管减压术治疗老年人三叉神经痛的疗效.方法选取2015年1月至2016年6月间我院收治的96例老年三叉神经痛患者,其中48例采取经皮三叉神经半月神经节射频温控热凝术治疗并作为对照组,另48例采取三叉神经微血管减压术治疗并作为观察组.观察对比两组疗效.比较两组在术后1个月及术后1年、3年和5年的疼痛和手术并发症的严重程度评分.结果术后1个月,两组患者疼痛缓解评分、手术并发症严重程度评分及总体疗效评分对比差异均无统计学意义(均P<0.05);术后1年、3年和5年,观察组和对照组疼痛严重程度分别是[(0.55±0.39)分和(0.94±0.61)分,t=7.572,P=0.011],[(0.81±0.61)分和(1.19±0.83)分,t=7.513,P=0.012]和[(1.13±0.65)分和(1.55±0.91)分,t=7.837,P=0.010]分;手术并发症严重程度分别是[(0.39±0.28)分和(0.67±0.49)分,t=7.290,P=0.014],[(0.65±0.37)分和(0.94±0.55)分,t=7.353,P=0.013]和[(0.80±0.35)分和(1.13±0.64)分,t=7.475,P=0.012]分;总体疗效为两类疼痛和手术后并发症严重程度评分,分别是[(0.72±0.35)分和(1.33±0.56)分,t=7.701,P=0.009]分,[(1.21±0.49)分和(1.78±0.70)分,t=7.580,P=0.011]分和[(1.46±0.55)分和(2.24±1.03)分,t=8.026,P=0.007]分;观察组上述三项评分在1年,3年和5年均低于对照组.结论对于老年三叉神经痛患者,微血管减压术疗效确切、疼痛缓解持续时间长、手术并发症发生率低,安全可靠,值得在临床中推广应用.

Objective To observe the efficacy of trigeminal nerve microvascular decompression in the treatment of elderly trigeminal neuralgia.Methods A total of 96 elderly patients with trigeminal neuralgia admitted to our hospital from January 2015 to June 2016 were selected.48 patients were treated with percutaneous trigeminal semilunar ganglion radiofrequency thermocoagulation as a control group,and the other 48 patients were treated with trigeminal nerve microvascular decompression as the observation group.Efficacy indicators of post-operative pain severity scores.severity scores of post-operative complications,a sum of two categories of severity scores»which were compared between the two groups at one month and at 1,3,5 years after surgery.Results One month after the operation,there was no significant differences in pain severity score,surgical complications severity scores,and a sum of two categories severity scores between the two groups of patients(all P>0.05).In the observation group versus the control group,pain severity scores were[(0.55+0.39)scores versus(0.94+0.61)scores,t=7.572,P=0.011 at 1 year after operation].[(0.81±0.61)versus(1.19+0.83)scores,t=7.513,P=0.012 at 3 years after operation]and[(1.13±0.65)and(l.55+0.91)scores,t=7.837,P=0.010 at 5 years after operation]respectively,showing more efficacy in observation group.In the observation group versus the control group,severity scores of surgical complications were[(0.39±0.28)and(0.67+0.49)scores,t=7.290,P=0.014,at 1 year after operation],[(0.65 dz 0.37)and(0.94±0.55)scores,t=7.353,P-0.013 at 3 years after operation]and[(0.80±0.35)and(1.13 dz 0.64)scores.t=7.475.P=0.012 at 5 years after operationj,respectively,showing more efficacy in observaiion group.In the observation group versus the control group,overall efficacy from a sum of the two categories of severity scores were[(0.72±0.35)and(1.33± 0.56)scorets.t=7.701.P=0.009 at 1 year after operation],[(1.21±0.49)and(1.78±0.70)scores,t=7.580,P=0.011 at 3 years after operation]and[(1.46±0.55)and(2.24±1.03)scores.t=8.026,P=0.007 at 5 years after operation].respectively・showing more efficacy in observation group.Overall.above three severity scores were lower than in the observation group than in the control group(all P<0.05).Conclusions For elderly patients with trigeminal neuralgia,trigeminal nerve microvascular decompression has definile efficacy,long duration of pain relief.low incidence of surgical complications»and is safe and reliable,which is worthy of clinical application.