神经内镜联合电生理监测在治疗原发性三叉神经痛的应用

doi:10.19854/j.cnki.1008-2425.2023.05.0003

摘要/Abstract

摘要： 目的探讨神经内镜联合电生理监测在微血管减压术(micro-vascular decompression,MVD)中治疗原发性三叉神经痛(trigeminal neuralgia,TN)的疗效及术后并发症情况。方法回顾性分析2016年1月至2022年12月镇江市第一人民医院和东南大学附属中大医院收治的142例原发性三叉神经痛患者的病例资料,其中66例在神经内镜联合电生理监测下行微血管减压手术(研究组),76例采用显微镜下行微血管减压手术(对照组),对两组的手术疗效和术后并发症发生情况进行分析。结果研究组的有效率为96.96%,对照组的有效率为96.05%,两组有效率相比较无统计学差异(P＞0.05)。两组中等级分布无统计学差异(P＞0.05),说明研究组的疗效和对照组同样确切。研究组的并发症发生率为10.60%,对照组的并发症发生率为14.47%,两组无统计学差异(P＞0.05)。其中研究组中的面听神经损伤的发生率明显小于对照组,具有统计学差异(P＜0.05)。结论神经内镜联合电生理监测下行微血管减压术治疗原发性三叉神经痛具有和传统显微镜相比同样确切的疗效,电生理监测可以在术中给予面听神经相应的保护,是一种治疗原发性三叉神经痛有效、安全的手术方法。

关键词: 神经内镜, 电生理监测, 三叉神经痛, 微血管减压

Abstract: Objective To explore the efficacy and postoperative complications of neuroendoscope combined with electrophysiological monitoring in the treatment of primary trigeminal neuralgia during microvascular decompression.Methods The clinical data of 142 patients with primary trigeminal neuralgia admitted to the First People's Hospital of Zhenjiang and Zhongda Hospital affiliated to Southeast University from January 2016 to October 2022 were retrospectively analyzed,including 66 patients who underwent microvascular decompression under neuroendoscope combined with electrophysiological monitoring (study group ) and 76 patients who underwent microvascular decompression under microscope (control group).The surgical effects and postoperative complications of the two groups were analyzed.Results The effective rate of the research group was 96.96%,while the effective rate of the control group was 96.05%.There was no statistically significant difference in the effective rates between the two groups (P＞0.05).There was no statistical difference in the grade distribution between the two groups (P＞0.05),indicating that the efficacy of the study group was as accurate as that of the control group.The incidence of complications in the study group was 10.60%,while the incidence of complications in the control group was 14.47%.There was no statistically significant difference between the two groups (P＞0.05).The incidence of facial auditory nerve injury in the study group was significantly lower than that in the control group,with a statistical difference (P＜0.05).Conclusion Neuroendoscope combined with electrophysiological monitoring for microvascular decompression in the treatment of primary trigeminal neuralgia has the same exact effect as that of traditional microscope.Electrophysiological monitoring can give corresponding protection to facial and auditory nerves during the operation,which is an effective and safe surgical method for the treatment of primary trigeminal neuralgia.

Key words: Neuroendoscope, Electrophysiological monitoring, Trigeminal neuralgia, Microvascular decompression

中图分类号:

R745.1⁺1

陈弘韬, 湛利平, 陈波, 吴琦, 王润培, 郭晓远. 神经内镜联合电生理监测在治疗原发性三叉神经痛的应用[J]. 立体定向和功能性神经外科杂志, 2023, 36(5): 269-273.

Chen Hongtao, Zhan Liping, Chen Bo, et al. Application of neuroendoscope combined with electrophysiological monitoring in the treatment of primary trigeminal neuralgia[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2023, 36(5): 269-273.

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