术中球囊扩张容积-Meckel腔体积比值与PMC治疗原发性三叉神经痛疗效的关系

Relationship between ratio of intraoperative balloon dilatation volume to Meckel volume and surgical efficacy of percutaneous microballoon compression for patients with primary trigeminal neuralgia

目的探讨术中球囊扩张容积-Meckel腔体积比值与经皮穿刺微球囊压迫术(PMC)治疗原发性三叉神经痛(PTN)疗效的关系。方法回顾性分析2019年3月至2021年8月PMC治疗的41例PTN的临床资料。术前MRI三维重建扫描测定Meckel腔体积,计算术中球囊扩张容积与Meckel腔体积的比值。术后随访6~18个月,末次随访参考巴罗德神经病学研究所疼痛预后分级(BNI)评估疗效,其中Ⅰ~Ⅱ级为有效,Ⅲ~Ⅴ级为无效。结果末次随访,有效31例,无效10例。有效组和无效组Meckel腔体积(0.43±0.20 cm^(3) vs.0.51±0.22 cm^(3))、术中球囊扩张容积(0.61±0.23 ml vs.0.49±0.20 ml)均无统计学差异(P>0.05),而有效组术中球囊扩张容积与Meckel腔体积的比值(1.46±0.26)明显大于无效组(0.98±0.12;P<0.05)。结论通过术前测量Meckel腔体积,以球囊扩张容积-Meckel腔体积比值的有效区间为参考依据,术中对球囊扩张容积进行把控,可提高PMC治疗PTN的疗效。

Objective To investigate the relationship between the ratio of intraoperative balloon dilatation volume to Meckel volume and the surgical efficacy of percutaneous microballoon compression(PMC)for patients with primary trigeminal neuralgia(PTN).Methods The clinical data of 41 patients with PTN treated with PMC from March 2019 to August 2021 were retrospectively analyzed.The volume of Meckel cavity was measured by MRI three-dimensional reconstruction scanning before surgery,and the ratio of intraoperative balloon expansion volume to Meckel cavity volume was calculated.The patients were followed up for 6~18 months.At the last follow-up,the Barod Neurological Institute Pain Prognosis Scale(BNI)was used to evaluate the efficacy,and gradesⅠ~Ⅱwere effective and gradesⅢ~Ⅴwere ineffective.Results At the last follow-up,31 patients were effective and 10 patients were ineffective.There were no significant differences in Meckel cavity volume(0.43±0.20 cm^(3) vs.0.51±0.22 cm^(3))and intraoperative balloon dilation volume(0.61±0.23 ml vs.0.49±0.20 ml)between effective and ineffective groups(P>0.05).The ratio of balloon expansion volume to Meckel cavity volume in effective group(1.46±0.26)was significantly higher than that(0.98±0.12)in ineffective group(P<0.05).Conclusions By measuring the volume of Meckel cavity before surgery and taking the effective interval of the ratio of balloon dilated volume to Meckel cavity volume as reference,intraoperative control of balloon dilated volume can improve the efficacy of PMC in the treatment of PTN.