华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

三种径路射频热凝术治疗原发性三叉神经痛疗效分析

陈佐华,赵宗林,李明哲,杨永沛   

  1. 610083 成都军区总医院口腔科
  • 收稿日期:2001-08-25 修回日期:2001-08-25 出版日期:2001-08-20 发布日期:2001-08-20

Clinical Significance of Trigeminal Neuralgia Treated Using Radiofrequency Thermocoagulation (RFT) with Different Approaches

Chen Zuohua, Zhao Zonglin, Li Mingzhe, et al   

  1. Department of Stomatology, Chengdu Army General Hospital
  • Received:2001-08-25 Revised:2001-08-25 Online:2001-08-20 Published:2001-08-20

摘要:

目的:评价3种径路射频温控热凝术治疗原发性三叉神经痛的近、远期疗效。方法:对320例原发性三叉神经痛患者采用前侧路、侧路和颧下喙突前路3种术式进行射频温控热凝术治疗,随访1~6年,统计其疗效和复发率的关系。结果:320例三叉神经痛患者射频温控热凝术的首次止痛有效率前侧路为9513%,侧路及颧下喙突前路为 7313%,两相比较差异显著(P<0101)。远期效果中,3种术式的优良率以前侧路为最高9813%,L路9517%,Z路 9215%。第1次射频热凝术后有2911%病例复发,其中大多数经2、3、4次再治疗又获得完全止痛。手术径路与复发有明显关系,前侧路的复发率远低于其它两种径路(P<0101)。全组发生1例严重并发症(眶尖综合征)。结论: 前侧路法的首次止痛有效率高,止痛时间长,复发率低。颧下喙突前路法可作为三叉神经Ⅱ支痛的一种替代和补充。

关键词: 射频温控热凝术, 三叉神经痛, 前侧路法, 颧下喙突前路法

Abstract:

Objective:The authors presented the shortterm and long term effects of the trigeminal neuralgia treated by RFTwith anterior- lateral facial, lateral facial and trans-subzygomatic approaches.Methods:320 primary patients with trigeminal neuralgia were se- lected for this study. All these patientswere followed up with the period of 1 to 6 years.Results:The first-time effective ratios of pain-relieve treated by using the anterior-lateral facial approach, and the lateral facial and the trans-subzygomatic, were 9313% and 7313% respectively.1Mostof the patients (9215%) achieved excellentorgood pain-relieve after treated by one of these three approaches. Compared with the lateral facial and trans-subzygomatic procedures, the anterior-lateral facial approach caused less recurrent rate in long term effects (P<0101). The late recurrence was found in 93 patients, but pain-relieve effect still could be obtained by retreatingwith the formermethod and without difficulty or hazard. One patient had serious Rollets syndrome.Conclu- sion:It is concluded that the anterior-lateral approach is a method with more effective pain-relieve and less pain recurrence rate, and the trans-subzygomatic method can be used as a substitutive approach in the treatmentof the second branch of trigminal neural- gia.

Key words: radiofrequency, thermocoagulation, trigeminal neuralgia, anterior-lateral facial approach, transsubzygomatic approach