球囊压迫术治疗三叉神经痛时标准梨形球囊与非梨形球囊的疗效比较

Association of efficacy with balloon shapes in percutaneous balloon compression for trigeminal neuralgia

目的比较经皮穿刺球囊压迫术(PBC)治疗三叉神经痛时标准梨形球囊与非梨形球囊的疗效及并发症情况。方法选取2017年5月至2019年1月浙江大学医学院附属杭州市第一人民医院收治的原发性三叉神经痛行PBC的患者70例,根据术中影像模式变化分为标准梨形与非梨形两组,比较两组患者术后疼痛缓解率及并发症(面部麻木、咀嚼肌无力、味觉减退)发生率。结果PBC中球囊形状的变化遵循特定的模式;标准梨形组患者疼痛缓解率明显高于非梨形组,差异有统计学意义(P<0.01);两组患者术后均无严重并发症,面部麻木、咀嚼肌无力、味觉减退发生率比较差异均无统计学意义(均P>0.05)。结论PBC治疗三叉神经痛安全有效;标准梨形球囊患者手术效果优于非梨形球囊患者。

Objective To investigate the efficacy of percutaneous balloon compression(PBC)with balloon shapes in treatment of trigeminal neuralgia.Methods Clinical data of 70 patients with primary trigeminal neuralgia treated with PBC in Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine from May 2017 to January 2019 were retrospectively reviewed.The intraoperative images of balloons presented pear-shaped(n=59)or non-pear-shaped(n=11)according to the pattern change.The patients were followed up for more than 2 years,the association of clinical efficacy and complications were compared between two groups of balloon shapes.Results The balloon shape changed during PBC procedures and followed a specific pattern.There were no serious postoperative complications in both groups.The efficacy of PBC in pear-shaped balloon group was better than that of non-pear-shaped balloon group(88.1%vs.54.5%,P<0.01).Conclusion PBC is safe and effective in the treatment of trigeminal neuralgia,patients with a pear-shaped balloon in imaging during PBC have better clinical efficacy than that with non-pear-shaped balloon images.It should be achieved as much as possible during the PBC procedures.