CAJ | 학술논문

目的探讨CRW立体定向导航系统以及三维CT在三叉神经半月节射频热凝术中的应用价值.方法广东省第二人民医院自2007年7月至2009年12月共收治124例原发性三叉神经痛患者,均采用CRW立体定向系统辅助下经皮穿刺卵圆孔,再在三维CT辅助下进针到达半月节切迹,方波刺激及预毁损确认穿刺到位后,采取逐渐加温的方式进行毁损.结果 124例患者均穿刺成功,无穿刺副损伤所致并发症.一次穿刺成功89例(71.8%),二次穿刺成功33例(26.6%),2例(1.6%)因颅底骨质结构有变异,经多次穿刺成功.术后即刻总体有效率为98.4%.术后出现患侧面部麻木感即浅感觉减退87例(70.2%),1例患者出现角膜炎(0.8%),未出现复视、咀嚼无力、张口困难等并发症.所有患者随访3月～2年,复发7例(5.6%).结论采用立体定向导航系统及三维CT重建可以大大提高穿刺卵圆孔的准确性,减少并发症:个体化穿刺策略的制定可以进一步确保疗效,提高治愈率.
목적 탐토CRW입체정향도항계통이급삼유CT재삼차신경반월절사빈열응술중적응용개치.방법 광동성제이인민의원자2007년7월지2009년12월공수치124례원발성삼차신경통환자,균채용CRW입체정향계통보조하경피천자란원공,재재삼유CT보조하진침도체반월절절적,방파자격급예훼손학인천자도위후,채취축점가온적방식진행훼손.결과 124례환자균천자성공,무천자부손상소치병발증.일차천자성공89례(71.8%),이차천자성공33례(26.6%),2례(1.6%)인로저골질결구유변이,경다차천자성공.술후즉각총체유효솔위98.4%.술후출현환측면부마목감즉천감각감퇴87례(70.2%),1례환자출현각막염(0.8%),미출현복시、저작무력、장구곤난등병발증.소유환자수방3월～2년,복발7례(5.6%).결론 채용입체정향도항계통급삼유CT중건가이대대제고천자란원공적준학성,감소병발증:개체화천자책략적제정가이진일보학보료효,제고치유솔.
Objective To investigate the value of CRW stereotactic navigation system and three-dimensional-CT in the radiofrequency thermocoagulation for primary trigeminal neuralgia.Methods One hundred and twenty-four patients with primary trigeminal neuralgia were treated with percutaneous radio-frequency thermocoagulation with the aid of CRW stereotactic system and three-dimensional CT. Results All of 124 patients were punctured successfully without any complications. Eighty-nine patients (71.8%) were punctured successfully at nce,33 patients(26.6%)were punctured successfully at twice. Because of the variation of the skull bottom, 2 patients (1.6%) were punctured successfully at many times. The effective rate of thermocoagulation is 98.4%. Eighty-seven patients (70.2%) appeared facial sensory decline and 1 (0.8%) appeared keratitis after operation; no such complications as diplopia, masticatory atonia and difficulty in opening mouth appeared. Seven patients (5.6%) relapsed after follow-up for 3 months to 2 years. Conclusion A stereotactic and CT reconstruction can greatly improve the accuracy of puncturing on the foramen ovale, reduce the complications and help to adopt an individualized puncture strategy, which can ensure the effectiveness and increase the cure rate.