CT引導下半月節熱凝射頻術延長時間對老年復發三叉神經痛療效及安全性的影響

楊立強++李博++趙丹++倪家驤++何亮亮

[摘要] 目的 觀察CT引導下增加半月節射頻時間對老年復發三叉神經痛療效及安全性的影響。 方法 將2008年10月～2015年5月就診于首都醫科大學宣武醫院疼痛科70例復發的單支三叉神經痛老年患者納入研究，采用隨機數字表法將其分為兩組，實驗組（36例）術中給予75℃熱凝射頻180 s，對照組（34例）給予75℃熱凝射頻120 s。評估患者術后24 h、7 d、3個月及1年的巴羅神經學研究所（BNI）分級、疼痛緩解滿意度、面部不良反應發生情況。 結果 術后1年，實驗組疼痛緩解滿意度為85.1%，明顯高于對照組的75.6%，差異有統計學意義（P < 0.05）。術后24 h，實驗組麻木評分[（8.88±0.98）分]較對照組[（6.36±0.45）分]明顯升高，差異有統計學意義（P < 0.05）；兩組術后7 d、3個月及1年的麻木評分比較，差異無統計學意義（P > 0.05）。兩組患者均未見任何嚴重的不可逆性并發癥發生。 結論 增加CT引導下半月節射頻時間能提高老年復發三叉神經痛患者的短期及長期療效，短期內面部麻木程度稍有加重，但仍是安全的。

[關鍵詞] 熱凝射頻術；三叉神經痛；復發；CT

[中圖分類號] R745.1 [文獻標識碼] A [文章編號] 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.