CAJ | 학술논문

目的：探讨原发性典型与不典型三叉神经痛微血管减压术治疗的临床效果。方法选择原发性典型与不典型三叉神经痛患者各40例，在全身麻醉气管插管下完成微血管减压术，比较2组术中所见血管压迫来源、压迫程度及血管压迫位置。结果典型三叉神经痛组压迫血管来源为单纯动脉占85.0％，显著高于非典型三叉神经痛组的57.5％（ P＜0.05）；来源为动静脉混合占15.0％，显著低于非典型三叉神经痛组的42.5％（ P＜0.05）；典型三叉神经痛组血管与神经位置接触者显著高于非典型三叉神经痛者（P＜0.05），术中发生三叉神经出现萎缩者比例显著少于非典型三叉神经痛者（P＜0.05），典型三叉神经痛者其压迫血管在近端者显著多于非典型三叉神经痛者（P＜0.05），压迫血管在远端者显著少于非典型三叉神经痛者（ P＜0.05）。结论原发性三叉神经痛实施血管减压术，术前鉴定其发病特点，在预测其压迫血管类型、位置及其与神经的关系具有一定临床价值。
목적：탐토원발성전형여불전형삼차신경통미혈관감압술치료적림상효과。방법선택원발성전형여불전형삼차신경통환자각40례，재전신마취기관삽관하완성미혈관감압술，비교2조술중소견혈관압박래원、압박정도급혈관압박위치。결과전형삼차신경통조압박혈관래원위단순동맥점85.0％，현저고우비전형삼차신경통조적57.5％（ P＜0.05）；래원위동정맥혼합점15.0％，현저저우비전형삼차신경통조적42.5％（ P＜0.05）；전형삼차신경통조혈관여신경위치접촉자현저고우비전형삼차신경통자（P＜0.05），술중발생삼차신경출현위축자비례현저소우비전형삼차신경통자（P＜0.05），전형삼차신경통자기압박혈관재근단자현저다우비전형삼차신경통자（P＜0.05），압박혈관재원단자현저소우비전형삼차신경통자（ P＜0.05）。결론원발성삼차신경통실시혈관감압술，술전감정기발병특점，재예측기압박혈관류형、위치급기여신경적관계구유일정림상개치。
Objective To investigate the effect of microvascular decompression on treating primary typical and atypical tri‐geminal neuralgia .Methods 40 cases with primary typical and 40 cases with atypical trigeminal neuralgia were chosen ,all of which were completed microvascular decompression under general anesthesia and endotracheal intubation .The origin of com‐pressed blood vessels ,the degree and position of compression were compared in two groups .Results Compressed blood ves‐sels originated from simple artery in typical group accounted for 85 .0% ,which was significantly higher than 57 .5% of atypical group(P<0 .05);and originated from mixed arteriovenous accounted for 15 .0% ,which was significantly lower than 42 .5% of the atypical group(P<0 .05) .The number of nerve and vessel rather closing together and compression in vascular proximity of typical group were significantly higher than that of atypical group in operation (P<0 .05) ,and the number of atrophy of tri‐geminal nerve and compression in vascular distance of typical group were significantly less than that of atypical trigeminal neu‐ralgia(P<0 .05) .Conclusion Trigeminal neuralgia treated with microvascular decompression and characteristics identified be‐fore operation can predict vascular compression type ,position and its relationship with nerves .