Microvascular decompression combined with trigeminal nerve combing in the treatment of recurrent trigeminal neuralgia

doi:10.19854/j.cnki.1008-2425.2022.03.0002

Abstract

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

摘要： 目的探讨微血管减压术联合三叉神经梳理术治疗复发性三叉神经痛的临床疗效及其安全性。方法收集十堰市太和医院神经外科2011年1月至2019年12月81例复发性三叉神经痛患者,根据手术方式将其分为2组:三叉神经微血微血管减压术和三叉神经微血管减压术联合三叉神经根梳理术组.分析两组术后有效率,疼痛复发率及并发症发生率.结果微血管减压术联合神经梳理术与单纯微血管减压术有效率分别为97.8%和91.4%,两者之间无统计学差异(P＞0.05).在术中如果蛛网膜粘连非常严重,无法完全松解,选择行微血管减压术联合神经梳理术患者有效率为86.7%,单纯行微血管减压术患者(71.8%),无明显差异(P＞0.05).对于蛛网膜粘连完全松解患者,在有效率(100.0% vs.100.0%)和复发率 (0% vs.13.3%)上,二者之间有效率无明显差异.随访时间为17~45个月,联合手术患者复发率(15.2%)与单纯微血管手术组(11.4%)无明显差异(P＞0.05)。对于粘连严重无法分离患者,联合手术组复发率低于单纯微血管减压组复发率(17.6% vs.30.8%),有统计学意义(P＜0.05)。结论通过回顾性分析显示行单纯微血管减压术或行微血管减压术联合三叉神经根梳理术均能有效治疗三叉神经痛.相对单纯微血管减压术而言,对于蛛网膜粘连严重患者,微血管减压术联合三叉神经根梳理术能更有效的降低复发率。

关键词: 复发性三叉神经痛, 微血管减压术, 三叉神经梳理术

CLC Number:

R745.1⁺1

Zhou Ping, Den Yan, Liu Kianjun, et al. Microvascular decompression combined with trigeminal nerve combing in the treatment of recurrent trigeminal neuralgia[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2022, 35(3): 133-137.

周平, 邓燕, 刘开军, 李进榜, 汤朝阳, 张霞, 王辉. 微血管减压术联合三叉神经梳理术治疗复发性三叉神经痛疗效分析[J]. 立体定向和功能性神经外科杂志, 2022, 35(3): 133-137.

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