影像引导下经皮半月节球囊压迫术治疗原发性三叉神经痛50例分析

Efficacy analysis on percutaneous balloon compression for treatment of 50 patients with primary trigeminal neuralgia guided by imaging

目的探讨数字化减影血管造影(DSA)引导下经皮半月节球囊压迫术治疗原发性三叉神经痛的临床疗效。方法回顾性分析暨南大学医学院附属脑科医院2019年1月—2021年10月在DSA引导下行经皮半月节球囊压迫术治疗并有效随访的50例原发性三叉神经痛患者临床及随访资料。对性别、年龄、病程、患侧、球囊形态、面部麻木程度、疼痛复发和疗效的关系进行统计学分析。结果术后疼痛即刻缓解率100%。随访期间9例疼痛复发,短期复发率18.0%;治愈44例,治愈率88.0%;显效3例、有效1例、无效2例,有效率96.0%。患者年龄、性别、患侧、病程、球囊形态与疗效的差异无统计学意义(P>0.05)。面部麻木程度、疼痛复发与疗效差异有统计学意义(P<0.05)。结论DSA引导下经皮半月节球囊压迫术治疗原发性三叉神经痛微创、有效。术后面部麻木程度≤Ⅱ分和疼痛复发是影响临床疗效的两个主要因素。

Objective To investigate the clinical effect of percutaneous balloon compression(PBC)guided by DSA in the treatment of primary trigeminal neuralgia(PTN).Methods The clinical and follow-up data of 50 patients with PTN treated by PBC under DSA from January 2019 to October 2021 in Affiliated Brain Hospital of Medical College of Jinan University were analyzed retrospectively.The relationship between gender,age,course of disease,affected side,balloon shape,degree of facial numbness,pain recurrence and curative effect was statistically analyzed.Results The pain immediate relief rate after operation was 100%.During the follow-up,9 pain recurred,and the short-term recurrence rate was 18.0%.44 were cured,and the cure rate was 88.0%.3 were markedly effective.1 was effective.2 were ineffective.The effective rate was 96.0%.Age,gender,affected side,course of disease,balloon shape had no significant differences in efficacy(P>0.05).The degree of facial numbness and pain recurrence had statistically significant difference in efficacy(P<0.05).Conclusions DSA-guided PBC for the treatment of PTN is minimally invasive and effective.The degree of postoperative facial numbness≤Ⅱgrade and pain recurrence are two main factors affecting the clinical efficacy.