关键词: 复发性三叉神经痛, 微血管减压术, 三叉神经梳理术

Abstract: Objective To investigate the clinical efficacy and safety of microvascular decompression combined with trigeminal nerve combing in the treatment of recurrent trigeminal neuralgia.Methods 81 patients with recurrent trigeminal neuralgia in the Department of Neurosurgery of Taihe Hospital of Shiyan City from 2011 to 2019 were collected and divided into two groups according to the operation method.35 patients underwent trigeminal extravascular decompression alone,and 46 patients underwent trigeminal microvascular decompression combined with trigeminal nerve root combing.The postoperative effective rate,pain recurrence rate and complication rate of the two groups were analyzed.Results The effective rates of microvascular decompression combined with nerve carding and simple microvascular decompression were 97.8% and 91.4% respectively,and there was no significant difference between them (P＞ 0.05).If the arachnoid adhesion was very serious and could not be completely released,microvascular decompression combined with nerve carding was selected.The effective rate of these patients was 86.7%,and that of patients with simple microvascular decompression was 71.8%,There was no significant difference (P＞0.05).For patients with complete release of arachnoid adhesion,there was no significant difference in the effective rate (100.0% vs.100.0%) and recurrence rate (0% vs.13.3%).The follow-up time was 17-45 months.There was no significant difference in the recurrence rate (15.2%) between the combined operation group and the simple microvascular operation group (11.4%) (P＞0.05).For patients with severe adhesion and no separation,The recurrence rate in the combined operation group was lower than that in the simple microvascular decompression group (17.6% vs 30.8%),which was statistically significant (P＜0.05).Conclusion Retrospective analysis shows that simple microvascular decompression and microvascular decompression combined with trigeminal nerve root combing can effectively treat trigeminal neuralgia.Compared with simple microvascular decompression,microvascular decompression combined with trigeminal nerve root combing can more effectively reduce the recurrence rate in patients with severe arachnoid adhesion.

Key words: Recurrent trigeminal neuralgia, Microvascular decompression, Trigeminal nerve combing