三叉神经痛微血管减压术与三叉神经痛半月节射频热凝术治疗三叉神经痛的疗效对比分析

Comparative Analysis of Trigeminal Neuralgia Microvascular Decompres⁃sion and Radiofrequency Thermocoagulation in the Treatment of Trigemi⁃nal Neuralgia

目的 探讨三叉神经痛的患者分别实施三叉神经痛微血管减压术与三叉神经痛半月节射频热凝术的临床效果。方法 随机选取2016年1月—2021年12月如皋博爱医院神经外科、疼痛科收治的84例三叉神经痛患者,通过双色球方案随机分为对照组和治疗组,每组42例。对照组实施三叉神经痛半月节射频热凝术,治疗组患者实施三叉神经痛微血管减压术,对比分析两组治疗后的临床效果,术前、术后视觉模拟疼痛评分(VAS),并发症发生率及复发率。结果 治疗组治疗有效率(97.62%)显著高于对照组,差异有统计学意义(χ^(2)=4.480,P<0.05);术前,两组患者的VAS评分比较,差异无统计学意义(P>0.05);术后两组患者VAS评分均降低,且治疗组VAS评分显著低于对照组,差异有统计学意义(P<0.05);两组并发症发生率(16.67%vs 47.62%)和复发率(4.76%vs 23.81%)比较,差异有统计学意义(χ^(2)=9.224、6.222,P<0.05)。结论 对三叉神经痛患者实施三叉神经痛微血管减压术的优势更加突出,治疗效果更好,并发症少,且复发少,可作为首选的治疗方式,但是对于高龄及具有开颅手术禁忌证的患者的可选择三叉神经痛半月节射频热凝术。

Objective To investigate the clinical effects of trigeminal neuralgia microvascular decompression and ra⁃diofrequency thermocoagulation in trigeminal neuralgia patients.Methods A total of 84 patients with trigeminal neu⁃ralgia admitted to the Department of Neurosurgery and Pain in Rugao Bo´ai Hospital from January 2016 to December 2021 were randomly selected.And they were randomly divided into control group and treatment group by bicolor sphere scheme,with 42 cases in each group.The control group received radiofrequency thermocoagulation of trigemi⁃nal neuralgia semilunar segment,and the treatment group received trigeminal neuralgia microvascular decompression.The clinical effects,Visual Analogue Score(VAS)before and after the treatment,complication rate and recurrence rate of the two groups were compared and analyzed.Results The response rate(97.62%)in the treatment group was significantly higher than the control group,the difference was statistically significant(χ^(2)=4.480,P<0.05).Before sur⁃gery,there was no statistically significant difference in VAS scores between the two groups(P>0.05);after surgery,the VAS score were reduced in both groups,and the VAS scores in the treatment group was significantly lower than the control group,the difference was statistically significant(P<0.05).Compared the two groups'complication rate(16.67%vs 47.62%)and the recurrence rate(4.76%vs 23.81%),the difference was statistically significant(χ^(2)=9.224,6.222,P<0.05).Conclusion For patients with trigeminal neuralgia,microvascular decompression of trigeminal neural⁃gia has more prominent advantages,better therapeutic effect,fewer complications,and less recurrence,which can be used as the preferred treatment.However,radiofrequency thermal coagulation of trigeminal neuralgia in the semilunar segment can be selected for the elderly and patients with contraindications to craniotomy.