显微血管减压术治疗三叉神经痛的疗效分析

Analysis of the therapeutic efficacy of microvascular decompression for trigeminal neuralgia

目的 探讨显微血管减压术治疗三叉神经的疗效 ,分析血管受压程度对治疗效果的影响。方法 系统性地回顾分析经显微血管减压术治疗的 3 9例三叉神经痛患者。结果 早期痊愈 3 7例 ( 94 9%) ,部分缓解 1例 ( 2 6%) ,无效 1例 ( 2 6%) ,无手术死亡。但随访 2～ 8年后 ,痊愈 3 3例 ( 84 6%) ,部分缓解 3例 ( 7 7%) ,无效 3例 ( 7 7%) ;复发 4例( 10 8%)。在晚期痊愈的病人中 ,三叉神经受动脉压迫出现明显压迹的 2 9例痊愈 2 7例 ( 93 1%) ,而神经与动脉或静脉接触而无压迹的 10例仅痊愈 6例 ( 60 %) ,二者差异显著 (P <0 0 5 )。结论 显微血管减压术治疗三叉神经痛是一安全有效的方法 。

Objective To evaluate the effect of microvascular decompression on trigeminal neuralgia and to analyze the relationship between the degree of vascular compression and the clinical outcomes. Methods Data from 39 trigeminal neuralgia cases dealt with microvascular decompression were retrospectively and systematically analyzed. Results Immediate complete relief was found in 37 cases (94.9%), partial relief in 1 case(2.6%) and failure in 1 (2.6%), but no death was found. After a follow up for 2～8 years, complete relief was found in 33 cases(84 6%), partial relief in 3 cases(7.7%), no marked changes in 3 cases (7.7%) and recurrence in 4 cases(10 8%). Twenty seven out of 29 cured patients with a marked notch on the trigeminal nerve because of artery compression were cured, but only 6 patients cured in 10 cases without marked notches( P <0 05). Conclusion Microvascular decompression is a safe and efficient way to treat trigeminal neuralgia, especially when there is a marked notch on the trigeminal nerve because of artery compression.