CT引导下经皮眶上孔、圆孔或卵圆孔射频热凝治疗原发性三叉神经痛的效果

Effect of CT-guided percutaneous radio frequency thermocoagulation in the treatment of primary trigeminal neuralgia through the foramina supraorbitale,circular or oval foramen

目的探讨CT引导下经皮眶上孔、圆孔或卵圆孔射频热凝(RFT)治疗原发性三叉神经痛(PTN)的效果。方法选取2020年1月至2021年12月高安市骨伤医院、高安市中医院收治的80例PTN患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各40例。对照组采用卡马西平治疗,观察组采用CT引导下经皮眶上孔、圆孔或卵圆孔RFT治疗。比较两组患者治疗效果、疼痛程度、生活质量、睡眠质量、疼痛发作频次及不良反应情况。结果观察组治疗优良率高于对照组,差异有统计学意义(P<0.05);治疗后,两组患者疼痛数字评分法(NRS)评分均低于本组治疗前,生活质量量表(SF-36)评分均高于本组治疗前,且观察组NRS评分低于对照组,SF-36评分高于对照组,差异有统计学意义(P<0.05);治疗后,两组患者匹兹堡睡眠质量指数量表(PSQI)评分及疼痛发作频次均低于本组治疗前,且观察组PSQI评分及疼痛发作频次低于对照组,差异有统计学意义(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论PTN患者采用CT引导下经皮眶上孔、圆孔或卵圆孔RFT治疗能够缓解疼痛程度,减少疼痛发作频次,提高患者生活质量及睡眠质量,且不良反应并未增加,临床应用安全性高。

Objective To investigate the effect of CT-guided percutaneous radio frequency thermocoagulation(RFT)in the treatment of primary trigeminal neuralgia(PTN)through the foramina supraorbitale,circular or oval foramen.Methods A total of 80 patients with PTN admitted to Gao'an Bone Trauma Hospital and Gao'an Traditional Chinese Medicine Hospital from January 2020 to December 2021 were selected as research objects,and they were divided into observation group and control group according to random number table method,with 40 cases in each group.The control group was treated with Carbamazepine,and the observation group was treated with CT-guided percutaneous RFT through the foramina supraorbitale,circular or oval foramen.The treatment effect,pain degree,quality of life,sleep quality,frequency of pain attack and adverse reactions were compared between the two groups.Results The rate of good treatment in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).After treatment,the scores of numerical rating scale(NRS)of two groups were lower than those before treatment,and the scores of the MOS item short form health survey(SF-36)were higher than those before treatment,and the NRS score of observation group was lower than that of control group,and the SF-36 score was higher than that of control group,with statistical significances(P<0.05).After treatment,the Pittsburgh sleep quality index(PSQI)score and pain attack frequency of two groups were lower than those before treatment,and the PSQI score and pain attack frequency of observation group were lower than those of control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The use of CT-guided percutaneous RFT for PTN patients through the foramina supraorbitale,circular or oval foramen can alleviate pain,reduce the frequency of pain attacks,improve the quality of life and sleep of patients,and no adverse reactions have been increased,and the clinical application is safe.