三叉神经节第Ⅰ支射频消融术改革术后管理预防角膜溃疡的效果

Reforming postoperative care to prevent the corneal ulcer after radiofrequency ablation of trigeminal neuralgia VⅠ

目的 回顾性总结三叉神经节第Ⅰ支射频消融术改革术后管理预防角膜溃疡的效果.方法 回顾我科2012年3月到2014年3月,诊断为原发性三叉神经第Ⅰ支痛并施行了三叉神经节射频消融术治疗的患者25例.改革术后管理措施为:取消原规定的术后每日角膜检查、滴眼药水的规定,改为强调外出佩戴平光眼镜,不揉搓眼睛的重要性.结果 患侧术后当日角膜反射正常5例、轻度减退10例、中度减退8例,消失2例;术后第1日、第30日、90日三个时段内未见角膜溃疡病例;术后第7日24例全停服卡马西平,1例减1/2量;出现轻度眼结膜于涩异物感3例,术后30日及90日消失.结论 三叉神经节第Ⅰ支射频消融术后改革患者管理措施,可有效防治角膜溃疡并发症.

Objective To retrospectively summarize the clinical effect of reforming patient care to prevent the corneal ulcer after radiofrequency ablation of trigeminal neuralgia V 1.Methods Twenty-five patients with trigeminal neuralgia V1 were treated with radiofrequency ablation.The reforming care methods after the operation were as following:cancelling the original routine of postoperative corneal examination and the eye drops every day;stressing the importance of putting on the glasses out of doors and not rubbing the eye if feeling pruritus postoperatively.Results The corneal reflex was normal in 5 cases,mild impaired in 10 cases,moderate impaired in 8 cases,disappeared in 2 cases on the first day after the operation.The prescribed carbamazepine was fully stopped in 24 cases,decreased 1/2 dosage in 1 case respectively on the seventy day.There were no corneal ulcer on the first,thirtieth,ninetieth days after the operation,3 patients suffered from mild eonjunctival sensation of dryness and foreign body sensation.The patients satisfaction rate is more than 92％.Conclusion Reforming the care methods after radiofrequency ablation of trigeminal neuralgia V1 could effectively prevent postoperative corneal ulcer.