射频热凝与阿霉素联合治疗顽固性三叉神经第一支痛的疗效

Radiofrequency thermocoagulation combined with adriamycin in the treatment of refractory first branch pain of the trigeminal nerve

目的:探究CT引导下射频热凝联合阿霉素局部注射治疗难治性三叉神经第一支痛的疗效及其对血清炎性因子的影响。方法:根据治疗方式不同,将98例行射频热凝术治疗三叉神经痛的患者分为研究组和对照组,每组各49例。对照组行CT引导下射频热凝手术治疗,研究组在对照组的基础上联用阿霉素局部注射。比较两组术前、术后3 d、出院前、术后1个月血清白细胞介素-6(IL-6)及C-反应蛋白(CRP)水平,并通过各时间点行Barrow神经学研究所(BNI)疼痛评分评价疼痛程度和术后疗效,探讨IL-6、CRP与BNI疼痛评分的相关性。结果:研究组术后3 d、出院前、术后1个月的治疗有效率均高于对照组(P<0.05)。术后各时间点,研究组血清IL-6水平均低于对照组(P<0.05),且血清CRP水平在出院前及术后1个月均低于对照组(P<0.05)。血清炎性因子IL-6、CRP水平与血清BNI疼痛程度呈正相关(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。结论:CT引导下射频热凝联合阿霉素治疗三叉神经第一支神经痛效果较显著,可有效下调血清炎性因子IL-6及CRP表达水平,降低不良并发症发生率,临床推广应用价值较高。

Objective:To explore the effect of CT-guided radiofrequency thermocoagulation combined with local injection of adriamycin in the treatment of refractory first branch pain of the trigeminal nerve and the influence of inflammatory factors.Methods:98 patients with trigeminal neuralgia treated by radiofrequency thermocoagulation were divided into study group and control group according to different treatment methods,with 49 cases in each group.The control group received CT-guided radiofrequency thermocoagulation surgery,and the study group received local injection of adriamycin on the basis of the control group.The serum interleukin-6(IL-6)and C-reactive protein(CRP)levels were compared between the two groups before operation,3 days after operation,before discharge,and 1 month after operation.The degree of pain and postoperative efficacy were evaluated by barrow institute of neurology(BNI)pain score at each time point,and the correlation between IL-6,CRP and BNI pain score were explored.Results:The effective rates in the study group 3 days after operation,before discharge,and 1 month after operation were higher than those of the control group(P<0.05).Serum IL-6 levels in the study group were lower than that in the control group at all time points after surgery(P<0.05),the serum CRP levels in the study group were significantly lower than that in the control group before discharge,and 1 month after operation(P<0.05).The levels of serum inflammatory factors IL-6 and CRP were positively correlated with the level of serum BNI pain(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion:CT-guided radiofrequency thermocoagulation combined with adriamycin has a significant effect on the treatment of the first branch of trigeminal nerve neuralgia.It can effectively reduce the level of serum inflammatory factors IL-6 and CRP,reduce the incidence of adverse complications,and has high clinical application value.