新型激光定位辅助经皮穿刺三叉神经微球囊压迫术治疗原发性三叉神经痛的临床研究

A clinical study on the treatment of primary trigeminal neuralgia with a new type of laser localization assisted percutaneous puncture of trigeminal nerve microsphere capsule compression surgery

目的探讨新型激光定位技术辅助经皮穿刺三叉神经微球囊压迫术治疗原发性三叉神经痛的临床效果及安全性分析。方法回顾性选取2020年1月至2021年12月湖南中医药大学第一附属医院收治行经皮穿刺三叉神经微球囊压迫术的原发性三叉神经痛患者63例,按照不同的手术方式分为新型激光定位辅助穿刺组(观察组,32例)和传统徒手定位穿刺组(对照组,31例)。分析两组患者手术时间、穿刺时间、穿刺次数、术中曝光射线量、球囊成形不良例数,术后6个月内的临床疗效等,并在术后6个月随访患者的预后情况。结果观察组的手术时间、穿刺时间、穿刺次数、术中曝光射线量均少于对照组,差异有统计学意义(均P<0.05)。观察组和对照组球囊成形不良例数、术后第1天巴罗神经研究所(BNI)疼痛评分分级比较差异无统计学意义(均P>0.05)。术后6个月内随访,两组患者面部麻木、复视、咬肌无力、唇周疱疹、疼痛复发的发生率比较,差异无统计学意义(均P>0.05)。结论激光定位技术可辅助手术精准穿刺卵圆孔,根据手术经验准确置入球囊,有助于提高手术的安全性,减少术后并发症和术中辐射剂量,短期随访疗效满意。

Objective To explore the clinical efficacy and safety analysis of a novel laser localization technology assisted percutaneous puncture of trigeminal nerve microsphere capsule compression surgery for the treatment of primary trigeminal neuralgia.Methods A retrospective selection was conducted on 63 patients with primary trigeminal neuralgia who underwent percutaneous puncture of the trigeminal nerve microsphere capsule compression surgery at the First Hospital of Hunan University of Chinese Medicine from January 2020 to December 2021.According to different surgical methods,they were divided into a new laser localization assisted puncture group(observation group)of 32 cases and a traditional barehanded localization puncture group(control group)of 31 cases.An analysis was conducted on the surgical time,puncture time,puncture frequency,intraoperative exposure to radiation,number of cases of poor balloon formation,and clinical efficacy within 6 months after surgery for two groups of patients.The prognosis of the patients was followed up at 6 months after surgery.Results The surgical time,puncture time,puncture frequency,and intraoperative exposure of the observation group were all less than those of the control group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference(P>0.05)in the number of cases of poor balloon angioplasty between the observation group and the control group,as well as the pain score grading of the Barlow Neurological Institute(BNI)on the first day after surgery.Within 6 months after surgery,there was no statistically significant difference in the incidence of facial numbness,diplopia,masseter weakness,perilabial herpes,and recurrent pain between the two groups of patients(all P>0.05).Conclusions Laser positioning technology can assist in precise puncture of the foramen ovale and accurate placement of balloons based on surgical experience,which helps to improve surgical safety,reduce postoperative complications and intraoperative radiation dose,and achieve satisfactory short-term follow-up results.