CAJ | 학술논문

目的：分析立体定向及三维悦栽引导经皮穿刺三叉神经半月节射频热凝(PRTTG)治疗三叉神经痛(TN)时产生心血管反应的原因及护理对策。方法对138例原发性TN患者局麻下行立体定向及三维CT引导下PRTTG，术中全程监测患者的心电图、心率、呼吸、血压、血氧饱和度。结果治疗TN138例中，有16例患者在穿刺卵圆孔过程中出现心率和血压下降，所有138例患者在行射频热凝时均出现心率及血压的升高，经积极干预，无发生心脑血管意外等重大并发症。结论立体定向导航及三维CT引导下PRTTG，密切观察患者心电及血压变化，是减轻患者心血管反应、保证手术顺利完成的关键。
목적：분석입체정향급삼유열재인도경피천자삼차신경반월절사빈열응(PRTTG)치료삼차신경통(TN)시산생심혈관반응적원인급호리대책。방법대138례원발성TN환자국마하행입체정향급삼유CT인도하PRTTG，술중전정감측환자적심전도、심솔、호흡、혈압、혈양포화도。결과치료TN138례중，유16례환자재천자란원공과정중출현심솔화혈압하강，소유138례환자재행사빈열응시균출현심솔급혈압적승고，경적겁간예，무발생심뇌혈관의외등중대병발증。결론입체정향도항급삼유CT인도하PRTTG，밀절관찰환자심전급혈압변화，시감경환자심혈관반응、보증수술순리완성적관건。
Objective To analyze the causes and nursing of cardiovascular responses of stereotactic percutaneous radiofrequency thermocoagulation of the trigeminal ganglion (PRTTG) for the treatment of trigeminal neuralgia (TN). Methods 138 patients with primary TN treated with CT-guided PRTTG under local anesthesia were analyzed. Patients' ECG, heart rate, respiration, blood pressure and oxygen saturations were monitored during the operation. Results There were 16 cases of decrease of heart rate and blood pressure during puncture of foramen ovale. All 138 cases had increased heart rate and blood pressure during radiofrequency. With positive intervention, no severe complication was occurred. Conclusions Stereotactic and CT-guided PRTTG, and close observation of the patients' ECG and blood pressure changes are the key points for reducing patients' cardiovascular responses, and ensuring the successful completion of surgery.