半月神经节射频热凝治疗不同程度血管关联性三叉神经痛的效果分析

Effect of radiofrequency thermocoagulation on semilunar ganglion in treating different degrees of vascular associated trigeminal neuralgia

目的观察三叉神经射频热凝治疗不同程度血管关联性三叉神经痛的临床疗效。方法采用回顾性分析纳入2015年9月—2020年11月安徽医科大学第一附属医院101例三叉神经痛患者,包括32例三叉神经与周围血管无关联患者(A组),40例三叉神经与周围血管密切相关患者(B组)和29例血管压迫三叉神经患者(C组)。3组均行CT引导半月神经节射频热凝术,观察并比较3组术前及术后1、3、6、12个月的VAS评分、生活质量、卡马西平使用剂量、治疗优良率。结果3组患者VAS评分比较差异有统计学意义,组间及组内不同时间点两两比较差异有统计学意义(F_(组间/时间/交互)=125.402,261.255,20.994;均P<0.05);3组患者卡马西平使用剂量比较差异有统计学意义,组间及组内不同时间点两两比较差异有统计学意义(F_(组间/时间/交互)=126.065,266.616,15.125;均P<0.05)。A组VAS评分和卡马西平使用剂量低于B组、C组(均P<0.05),B组与C组比较差异无统计学意义(均P>0.05)。3组患者手术后VAS评分、卡马西平使用剂量较手术前均明显下降(均P<0.05)。3组患者手术后生活质量明显升高(均P<0.05)。3组患者术后12个月治疗优良率分别为90.63%、82.50%、86.21%。结论CT引导半月神经节射频热凝术治疗三叉神经痛可明显缓解疼痛,提高患者生活质量,血管神经关联影响手术效果。

Objective To observe the clinical efficacy of trigeminal nerve radiofrequency thermocoagulation in the treatment of different degrees of vascular associated trigeminal neuralgia.Methods A total of 101 patients with trigeminal neuralgia from September 2015 to November 2020 in the First Affiliated Hospital of Anhui Medical University were enrolled in the retrospective analysis,including 32 patients with no trigeminal nerve associated with peripheral blood vessels(group A),40 patients with the trigeminal nerve closely related to peripheral vascular(group B)and 29 patients with vascular compression of trigeminal nerve(group C).Radiofrequency thermocoagulation of the semilunar ganglion guided by CT was performed in all three groups.Visual analogue scale(VAS),quality of life,carbamazepine dose and excellent and good rate of treatment were observed and compared before and after 1,3,6 and 12 months in the three groups.Results There were statistically significant differences in VAS scores among the 3 groups,and there were statistically significant differences between groups and at different time points within groups(F_(intergroup/time/interaction)=125.402,261.255,20.994;all P<0.05).There were statistically significant differences in the dose of carbamazepine among the 3 groups,and statistically significant differences between groups and at different time points within groups(F_(intergroup/time/interaction)=126.065,266.616,15.125;all P<0.05).VAS score and carbamazepine dose in group A were lower than those in group B and group C(all P<0.05),and there was no statistical significance between group B and group C(all P>0.05).VAS score and carbamazepine dose in three groups were significantly decreased after operation compared with before operation(all P<0.05).The quality of life of patients in the three groups was significantly improved after surgery(all P<0.05).The excellent and good rates of the three groups after 12 months were 90.63%,82.5%and 86.21%,respectively.Conclusion CT-guided radiofrequency thermocoagulation on semilunar ganglion can significantly relieve pain and improve the quality of life of patients with trigeminal neuralgia.Vascular nerve association affects the outcome of surgery.