CAJ | 학술논문

目的：比较单纯翼腭神经节射频热凝毁损术与半月神经节联合眶下神经射频热凝毁损术对单纯上颌支三叉神经痛患者生活质量的改善效果。方法259例原发性单纯上颌支三叉神经痛患者分为两组，分别予以单纯射频毁损翼腭神经节（单纯组，130例）和联合毁损半月神经节及眶下神经治疗（联合组，129例）。随访两年，比较两组患者的疼痛模拟视觉评分量表（VAS）评分、麻木评分、生活质量评分及复发率。结果（1）两组间VAS评分比较，差异无统计学意义（P＞0．05）；各组在术前、术后即时、术后6个月、术后12个月及术后24个月的VAS评分比较，差异均有统计学意义（P＜0．001），其中术后评分均低于术前。（2）术后两组患者均出现不同程度的所毁损神经支配区域的麻木感，但两组间麻木评分比较，差异无统计学意义（P＞0．05）；各组的麻木评分随时间延长而降低（P＜0．01）。（3）在生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能评分及生活质量总分等8个指标中，联合组优于单纯组（P＜0．05），而两组的精神健康评分比较，差异无统计学意义（P＞0．05）；各组术前、术后4周、术后24个月生活质量各指标评分的比较，差异有统计学意义（P＜0．05），术后评分优于术前。（4）两组患者1年复发率比较，差异无统计学意义（P＞0．05），单纯组术后2年复发率（32．2％）高于联合组（16．7％）（P＜0．05）。结论采用联合毁损半月神经节加眶下神经方法治疗单纯上颌支三叉神经痛能显著提高患者的生活质量，优于传统单纯翼腭神经节毁损方法。
목적：비교단순익악신경절사빈열응훼손술여반월신경절연합광하신경사빈열응훼손술대단순상합지삼차신경통환자생활질량적개선효과。방법259례원발성단순상합지삼차신경통환자분위량조，분별여이단순사빈훼손익악신경절（단순조，130례）화연합훼손반월신경절급광하신경치료（연합조，129례）。수방량년，비교량조환자적동통모의시각평분량표（VAS）평분、마목평분、생활질량평분급복발솔。결과（1）량조간VAS평분비교，차이무통계학의의（P＞0．05）；각조재술전、술후즉시、술후6개월、술후12개월급술후24개월적VAS평분비교，차이균유통계학의의（P＜0．001），기중술후평분균저우술전。（2）술후량조환자균출현불동정도적소훼손신경지배구역적마목감，단량조간마목평분비교，차이무통계학의의（P＞0．05）；각조적마목평분수시간연장이강저（P＜0．01）。（3）재생리궤능、생리직능、구체동통、일반건강상황、정력、사회공능、정감직능평분급생활질량총분등8개지표중，연합조우우단순조（P＜0．05），이량조적정신건강평분비교，차이무통계학의의（P＞0．05）；각조술전、술후4주、술후24개월생활질량각지표평분적비교，차이유통계학의의（P＜0．05），술후평분우우술전。（4）량조환자1년복발솔비교，차이무통계학의의（P＞0．05），단순조술후2년복발솔（32．2％）고우연합조（16．7％）（P＜0．05）。결론채용연합훼손반월신경절가광하신경방법치료단순상합지삼차신경통능현저제고환자적생활질량，우우전통단순익악신경절훼손방법。
Objective To compare the improvements in quality of life between simplex pterygopalatine ganglion radiofrequency ablation and semilunar ganglion combined with infraorbital nerve radiofrequency ablation in patients with trigeminal neuralgia of maxillary branch .Methods Two hundred and fifty-nine patients with primary trigeminal neuralgia of maxillary branch were divided into two groups . One group was treated with simplex pterygopalatine ganglion radiofrequency ablation (simplex group,n=130),and the other group was treated with semilunar ganglion combined infraorbital nerve radiofrequency ablation ( combination group ,n=129) .During the follow-up of two years , the visual analogue scale ( VAS) score,numbness score ,quality of life and recurrence rate were compared between two groups .Results①There was no significant difference in VAS score between two groups (P>0.05).Before operation,at the instant of complishment ,6,12 and 24 months after operation,the significant differences in VAS scores were observed for each group (P<0.001),and the postoperative scores were all lower than the preoperative scores .②The numbness with various degree occurred postoperatively in the ranges dominated by the impaired nerves in two groups,but there was no significant difference in the numbness score between two groups (P>0.05).The numbness scores in each group decreased with the increasing time (P<0.01).③Combination group was superior to simplex group in the assessments of physical function,role-physical,bodily pain,general health,vitality,social function and role-emotional,and the total score of quality of life(P<0.05),but there was no significant difference in the score of mental health between two groups(P>0.05).Before operation, 4 weeks and 24 months after operation,significant differences in all indices of quality of life were observed for each group (P<0.05),and the postoperative scores were superior to the preoperative score .④There was no significant difference in the one-year recurrence rate between two groups(P>0.05),but the two-year recurrence rate of simplex group was higher than that of combination group(32.2%vs.16.7%,P<0.05). Conclusion Semilunar ganglion combined with infraorbital nerve radiofrequency ablation can significantly improve the quality of life of patients with trigeminal neuralgia of maxillary branch,and it is superior to traditional simplex pterygopalatine ganglion radiofrequency ablation.