射频热凝术与微血管减压术治疗三叉神经痛效果的Meta分析

Meta-analysis of Efficacy of Radiofrequency Thermocoagulation and Microvascular Decompression in the Treament of Trigeminal Neuralgia

目的:采用Meta分析评价射频热凝术(radiofrequency thermocoagulation,RFT)与微血管减压术(microvascular decompression,MVD)治疗三叉神经痛(trigeminal neuralgia,TN)的有效性和安全性。方法:通过计算机检索Embase、Cochrane Library、PubMed、中国知网、维普网、万方数据库等中英文数据库,检索时限为建库开始至2021年8月。选取包含RFT与MVD治疗TN的临床研究,使用RevMan 5.3软件进行Meta分析。结果:纳入19篇文献,共2698例TN患者。Meta分析显示,MVD组的有效率高于RFT组[OR=0.45,95%CI(0.30,0.69),P=0.0002],MVD组的治愈率高于RFT组[OR=0.26,95%CI(0.16,0.42),P<0.00001],RFT组有更高的术后面部麻木发生率[OR=2.84,95%CI(1.28,6.30),P=0.01]及复发率[OR=3.56,95%CI(2.25,5.63),P<0.00001],两组术后并发症发生率差异无统计学意义[OR=0.91,95%CI(0.64,1.30),P=0.61]。结论:TN患者进行MVD手术可以获得更好的临床疗效,术后复发率更低,而RFT创伤小,可以作为一种替代的治疗选择。

Objective:To assess the effectiveness and safety of radiofrequency thermocoagulation(RFT)and microvascular decompression(MVD)in the treatment of trigeminal neuralgia(TN)by Meta-analysis.Method:Clinical researches on RFT and MVD for TN were searched in Embase,Cochrane Library,PubMed,CNKI,VIP,Wanfang from the date of inception to August 2021.A Meta-analysis was conducted by RevMan 5.3 software.Result:A total of 19 studies involving 2698 TN patients were enrolled.Meta-analysis results showed that the effective rate[OR=0.45,95%CI(0.30,0.69),P=0.0002]and cure rate[OR=0.26,95%CI(0.16,0.42),P<0.00001]of the MVD group were higher than the RFT group.Compared with the MVD group,the RFT group had a higher incidence of postoperative facial numbness[OR=2.84,95%CI(1.28,6.30),P=0.01]and recurrence[OR=3.56,95%CI(2.25,5.63),P<0.00001].There was no significant difference in the incidence of postoperative complications between the two groups[OR=0.91,95%CI(0.64,1.30),P=0.61].Conclusion:Compared with RFT,MVD has better clinical efficacy and lower postoperative recurrence rate in TN patients,and RFT can be used as an alternative treatment option.