CT引導(dǎo)下半月節(jié)熱凝射頻術(shù)延長(zhǎng)時(shí)間對(duì)老年復(fù)發(fā)三叉神經(jīng)痛療效及安全性的影響

楊立強(qiáng)++李博++趙丹++倪家驤++何亮亮

[摘要] 目的 觀察CT引導(dǎo)下增加半月節(jié)射頻時(shí)間對(duì)老年復(fù)發(fā)三叉神經(jīng)痛療效及安全性的影響。 方法 將2008年10月～2015年5月就診于首都醫(yī)科大學(xué)宣武醫(yī)院疼痛科70例復(fù)發(fā)的單支三叉神經(jīng)痛老年患者納入研究，采用隨機(jī)數(shù)字表法將其分為兩組，實(shí)驗(yàn)組（36例）術(shù)中給予75℃熱凝射頻180 s，對(duì)照組（34例）給予75℃熱凝射頻120 s。評(píng)估患者術(shù)后24 h、7 d、3個(gè)月及1年的巴羅神經(jīng)學(xué)研究所（BNI）分級(jí)、疼痛緩解滿意度、面部不良反應(yīng)發(fā)生情況。 結(jié)果 術(shù)后1年，實(shí)驗(yàn)組疼痛緩解滿意度為85.1%，明顯高于對(duì)照組的75.6%，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。術(shù)后24 h，實(shí)驗(yàn)組麻木評(píng)分[（8.88±0.98）分]較對(duì)照組[（6.36±0.45）分]明顯升高，差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）；兩組術(shù)后7 d、3個(gè)月及1年的麻木評(píng)分比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P > 0.05）。兩組患者均未見(jiàn)任何嚴(yán)重的不可逆性并發(fā)癥發(fā)生。 結(jié)論 增加CT引導(dǎo)下半月節(jié)射頻時(shí)間能提高老年復(fù)發(fā)三叉神經(jīng)痛患者的短期及長(zhǎng)期療效，短期內(nèi)面部麻木程度稍有加重，但仍是安全的。

[關(guān)鍵詞] 熱凝射頻術(shù)；三叉神經(jīng)痛；復(fù)發(fā)；CT

[中圖分類號(hào)] R745.1 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2017）01（b）-0085-04

Influence of time extension of percutaneous radiofrequency thermocoagulation for gasserian ganglion under the guidance of CT for the efficacy and safety of elderly patients with recurrent trigeminal neuralgia

YANG Liqiang1* LI Bo2* ZHAO Dan3 NI Jiaxiang1▲ HE Liangliang1 GUO Yu'na1 CAO Guoqing1

1.Department of Pain， Xuanwu Hospital， Capital Medical University， Beijing 100053， China； 2.Department of Neurology， Beijing Hepingli Hospital， Beijing 100013， China； 3.Department of Surgery， Beijing Northern Hospital， China North Industries Group Corporation， Beijing 100089， China

[Abstract] Objective To observe the influence of radiofrequency time extension of percutaneous radiofrequency thermocoagulation for gasserian ganglion under the guidance of CT for the efficacy and safety of elderly patients with recurrent trigeminal neuralgia. Methods Seventy cases of elderly patients with recurrent trigeminal neuralgia treated in Department of Pain， Xuanwu Hospital， Capital Medical University from October 2008 to May 2015 were enrolled into this study， they were divided into two groups by random number table method. The experimental group （36 cases） was given 75℃ radiofrequency thermocoagulation for 180 s， the control group （34 cases） was given 75℃ radiofrequency thermocoagulation for 120 s. The classification of Barrow neurological institute （BNI）， satisfaction degree of pain remission and the occurrence of facial reactions after operation for 24 h， 7 d， 3 months， 1 year were evaluated. Results After operation for 1 year， the satisfaction degree of pain remission in the experimental group was 85.1%， which was higher than that of control group （75.6%）， the difference was statistically significant （P < 0.05）. After operation for 24 h， the numb score in the experimental group [（8.88±0.98） points] was higher than that of control group [（6.36±0.45） points]， the difference was statistically significant （P < 0.05）； while there were no statistically significant differences of the numb scores after operation for 7 d， 3 months， 1 year between the two groups （P > 0.05）. Both groups had no serious irreversible complications. Conclusion Increasing the time of percutaneous radiofrequency thermocoagulation for gasserian ganglion under the guidance of CT can improve the short-term and long-term efficacy of elderly patients with recurrent trigeminal neuralgia， the degree of facial numb will be increased slightly in a short-term， but it is still safe.