中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
11期
50-53
,共4页
治疗结果%三叉神经痛%显微血管减压术
治療結果%三扠神經痛%顯微血管減壓術
치료결과%삼차신경통%현미혈관감압술
Treatment outcome%Trigeminal neuralgia%Microvascular decompression
目的 观察三叉神经痛(TN)患者实施显微血管减压术治疗的近期及远期疗效.方法 回顾性分析2008年12月至2011年11月应用显微血管减压术进行治疗的108例TN患者的临床资料,观察患者术后2年内疼痛的改善情况,同时结合年龄与病程,以及压迫血管的类型,是否出现明显压迫切迹等情况,对TN的复发因素予以分析.结果 术中发现全部患者均存在血管压迫,其中93例出现明显压迫切迹,包括存在动脉性压迫85例,静脉性压迫15例,动静脉联合压迫8例,其中动脉性压迫患者中有74例存在明显压迫切迹,而静脉性压迫中有11例出现明显压迫切迹,8例动静脉联合压迫均能够见到明显的压迫切迹.术后1周,患者动脉性压迫均获得明显改善,其中79例被判定为优,6例被判定为良;静脉性压迫患者9例效果达到优,6例达到良;而动静脉联合压迫患者5例效果达到优,3例达到良.在术后1年的随访中,5例动脉性压迫出现复发,其中3例为部分复发,2例为完全复发;6例静脉性压迫出现复发;2例动静脉联合压迫患者均出现完全复发.单因素分析结果显示,血管压迫类型、血管压迫切迹、病程为影响术后复发的危险因素(P＜0.01).多因素回归分析结果显示,血管压迫类型、血管压迫程度、病程为影响术后复发的独立危险因素(P＜0.05).结论 TN患者应用显微血管减压术进行治疗,效果确切,其中病程、血管压迫类型以及压迫程度是影响患者术后出现复发比较重要的因素.
目的 觀察三扠神經痛(TN)患者實施顯微血管減壓術治療的近期及遠期療效.方法 迴顧性分析2008年12月至2011年11月應用顯微血管減壓術進行治療的108例TN患者的臨床資料,觀察患者術後2年內疼痛的改善情況,同時結閤年齡與病程,以及壓迫血管的類型,是否齣現明顯壓迫切跡等情況,對TN的複髮因素予以分析.結果 術中髮現全部患者均存在血管壓迫,其中93例齣現明顯壓迫切跡,包括存在動脈性壓迫85例,靜脈性壓迫15例,動靜脈聯閤壓迫8例,其中動脈性壓迫患者中有74例存在明顯壓迫切跡,而靜脈性壓迫中有11例齣現明顯壓迫切跡,8例動靜脈聯閤壓迫均能夠見到明顯的壓迫切跡.術後1週,患者動脈性壓迫均穫得明顯改善,其中79例被判定為優,6例被判定為良;靜脈性壓迫患者9例效果達到優,6例達到良;而動靜脈聯閤壓迫患者5例效果達到優,3例達到良.在術後1年的隨訪中,5例動脈性壓迫齣現複髮,其中3例為部分複髮,2例為完全複髮;6例靜脈性壓迫齣現複髮;2例動靜脈聯閤壓迫患者均齣現完全複髮.單因素分析結果顯示,血管壓迫類型、血管壓迫切跡、病程為影響術後複髮的危險因素(P＜0.01).多因素迴歸分析結果顯示,血管壓迫類型、血管壓迫程度、病程為影響術後複髮的獨立危險因素(P＜0.05).結論 TN患者應用顯微血管減壓術進行治療,效果確切,其中病程、血管壓迫類型以及壓迫程度是影響患者術後齣現複髮比較重要的因素.
목적 관찰삼차신경통(TN)환자실시현미혈관감압술치료적근기급원기료효.방법 회고성분석2008년12월지2011년11월응용현미혈관감압술진행치료적108례TN환자적림상자료,관찰환자술후2년내동통적개선정황,동시결합년령여병정,이급압박혈관적류형,시부출현명현압박절적등정황,대TN적복발인소여이분석.결과 술중발현전부환자균존재혈관압박,기중93례출현명현압박절적,포괄존재동맥성압박85례,정맥성압박15례,동정맥연합압박8례,기중동맥성압박환자중유74례존재명현압박절적,이정맥성압박중유11례출현명현압박절적,8례동정맥연합압박균능구견도명현적압박절적.술후1주,환자동맥성압박균획득명현개선,기중79례피판정위우,6례피판정위량;정맥성압박환자9례효과체도우,6례체도량;이동정맥연합압박환자5례효과체도우,3례체도량.재술후1년적수방중,5례동맥성압박출현복발,기중3례위부분복발,2례위완전복발;6례정맥성압박출현복발;2례동정맥연합압박환자균출현완전복발.단인소분석결과현시,혈관압박류형、혈관압박절적、병정위영향술후복발적위험인소(P＜0.01).다인소회귀분석결과현시,혈관압박류형、혈관압박정도、병정위영향술후복발적독립위험인소(P＜0.05).결론 TN환자응용현미혈관감압술진행치료,효과학절,기중병정、혈관압박류형이급압박정도시영향환자술후출현복발비교중요적인소.
Objective To observe the short-term and long-term effect of microvascular decompression in patients with trigeminal neuralgia (TN).Methods The chnical data of 180 patients with TN treated with microvascular decompression were retrospectively analyzed.The pain improvement of patients in 2 years was observed,combined with age and course of disease,as well as the type of pressure vessels,whether obvious impression and so on,to analysis the recurrence factors of TN.Results All patients were found with vascular compression,including 93 cases with apparent pressure pressing mark,85 cases with arterial compression,15 cases with venous compression,and 8 cases with arteriovenous compression,among of them 74 patients with artery compression had pressure pressing mark,and 11 patients with vascular compression had pressure pressing mark,all of 8 patients with arteriovenous compression had pressure pressing mark.One week postoperatively,the patients with vascular compression gained significant improvement,of which 79 cases achieved optimal,6 cases achieved good;9 patients with vascular compression achieved optimal,6 cases achieved good,and 5 patients with arteriovenous compression achieved optimal,3 cases achieved good.Follow-up for 1 year after surgery,artery compression recurred in 5 cases,of which 3 cases of part recurrence,2 cases of recurrence completely ;vascular compression recurred in 6 cases;arteriovenous compression recurred in 2 cases.Univariate analysis showed that the vascular compression type,bascular compression notch and duration were the risk factors of postoperative recurrence (P ＜ 0.01).Multiple analysis showed that the vascular compression type,bascular compression degree and duration were the independent risk factors of postoperative recurrence (P ＜ 0.05).Conclusions TN patients treatd with microvascular decompression have effective improvement.History of diease,vascular compression type and compression degree are the important influence factors of postoperative recurrence.
