Abstract: Objective To study the perioperative safety and postoperative efficacy of percutaneous balloon compression(PBC) in patients with trigeminal neuralgia with heart disease,a retrospective analysis was performed on the clinical data of patients with trigeminal neuralgia with heart disease. Methods In June 2019 to March 2021 in our department application PBC treatment of primary trigeminal neuralgia patients,109 cases were selected,according to the presence of comorbid patients with heart disease can be divided into normal group and associated with heart disease,and according to whether intraoperative changes in heart rate decline,divided the patients into heart rate descent group and the group,the comparative analysis of two groups of patients with clinical data,The clinical efficacy,complications and perioperative problems of the two groups were compared and analyzed. Results There was no significant difference in the rate of pain relief 6 months after operation between the normal group and the group with heart disease.In the normal group,56 patients(84.8%) had complete pain relief 6 months after operation,and 10 patients(15.2%) still had pain;in the group with heart disease,40 patients(93.0%) had complete pain relief 6 months after operation,and 3 patients(7.0%) still had pain.The incidence of the decrease of the operation center rate in the group with heart disease was significantly higher than that in the normal group,13 cases(30.2%) of the operation center rate in the group with heart disease,6 cases(9.0%) of the normal group,P＜0.001.By comparing the clinical data of patients in the descending heart rate group and the non-descending group,it was found that the age of patients in the descending heart rate group was significantly older than that in the non-descending heart rate group,and the majority of patients in the descending heart rate group had heart disease. Conclusion PBC is an effective treatment for trigeminal neuralgia,and it is still reliable and safe for patients with trigeminal neuralgia with heart disease.For patients with heart disease,preoperative cardiac examination should be improved,and vital signs should be closely monitored before and during surgery.Timely treatment should be taken for cardiac disorders and other conditions occurred during surgery.

Key words: Trigeminal neuralgia, Percutaneous balloon compression, Cardiac diseases, Trigeminocardiac reflex, Anesthesia

摘要： 目的 为研究经皮球囊压迫术(percutaneous balloon compression,PBC)治疗伴心脏疾患的三叉神经痛患者的围手术期安全性及术后疗效,对伴有心脏疾患的三叉神经痛患者临床资料做一回顾性分析。方法 选择2019年6月至2021年3月在我科应用PBC治疗的原发性三叉神经痛病人共109例,将患者根据有无伴发心脏疾患分为正常组和伴心脏疾患组,并且根据术中是否出现心率下降变化,将患者分为心率下降组和非下降组,比较分析两组患者的临床资料,对比分析两组患者临床疗效及并发症以及围手术期相关问题。结果 正常组与伴心脏疾患组术后6个月的疼痛缓解率无明显差异,其中,正常组术后6个月疼痛完全缓解56例(84.8%),仍有疼痛10例(15.2%),伴心脏疾患组疼痛完全缓解40例(93.0%),仍有疼痛3例(7.0%)。伴有心脏疾患组术中心率下降的发生率显著高于正常组,其中伴有心脏疾患组术中心率下降13例(30.2%),正常组心率下降6例(9.0%),P＜0.001。比较心率下降组与非下降组患者临床资料,发现心率下降组患者的年龄显著大于非下降组,在心率下降组中伴有心脏疾患的患者占绝大数。结论 PBC是治疗三叉神经痛的有效治疗手段,对于伴有心脏疾患的三叉神经痛患者仍有可靠安全性。对于伴有心脏疾患的患者应完善术前心脏相关检查,术前及术中严密监测各项生命体征,如术中发生心脏失常等情况,应及时采取措施治疗。

关键词: 三叉神经痛, 经皮穿刺球囊压迫, 心脏疾患, 三叉神经心脏反射, 麻醉