CT引导下半月节热凝射频术延长时间对老年复发三叉神经痛疗效及安全性的影响

杨立强++李博++赵丹++倪家骧++何亮亮

[摘要] 目的 觀察CT引导下增加半月节射频时间对老年复发三叉神经痛疗效及安全性的影响。 方法 将2008年10月～2015年5月就诊于首都医科大学宣武医院疼痛科70例复发的单支三叉神经痛老年患者纳入研究，采用随机数字表法将其分为两组，实验组（36例）术中给予75℃热凝射频180 s，对照组（34例）给予75℃热凝射频120 s。评估患者术后24 h、7 d、3个月及1年的巴罗神经学研究所（BNI）分级、疼痛缓解满意度、面部不良反应发生情况。 结果 术后1年，实验组疼痛缓解满意度为85.1%，明显高于对照组的75.6%，差异有统计学意义（P < 0.05）。术后24 h，实验组麻木评分[（8.88±0.98）分]较对照组[（6.36±0.45）分]明显升高，差异有统计学意义（P < 0.05）；两组术后7 d、3个月及1年的麻木评分比较，差异无统计学意义（P > 0.05）。两组患者均未见任何严重的不可逆性并发症发生。 结论 增加CT引导下半月节射频时间能提高老年复发三叉神经痛患者的短期及长期疗效，短期内面部麻木程度稍有加重，但仍是安全的。

[关键词] 热凝射频术；三叉神经痛；复发；CT

[中图分类号] R745.1 [文献标识码] A [文章编号] 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.