C形臂或CT靶点定位射频治疗三叉神经痛2816例研究

【摘要】目的 介绍C形臂或CT靶点精确定位卵圆孔半月神经节选择性射频热凝治疗原发性三叉神经痛的手术方法、技巧和效果。方法 回顾性分析本组2816例射频治疗病例，术中采用C形臂X线或CT定位，靶点位于卵圆孔半月神经节，射频温控热凝术温度设定65-80℃，时间设定为30-60s。近、远期疗效观察并总结分析并发症。结果 本组近期随访病例2760例，疼痛完全消失2661例，总有效率96.41%，2年内复发率192例（6.9%），无效39例（1.4%）。结论 本手术方法弥补了传统的徒手穿刺的缺陷，提高了定位准确性和疗效。对行开颅微血管减压术（MVD）复发或无效的三叉神经痛患者可以做为一项补充治疗。对本病伴有高龄心脑血管疾病的患者仍是一种安全可靠的治疗方法。

【关键词】C形臂 CT定位 三叉神经痛 射频

A study of 2816 cases of trigeminal neuralgia treated by radiofrequency rhizotomy under C-arm Xay or CT-guided location target of

[ Abstract ] Objective To introduce the method 、skill and result of selective radiofrequency rhizotomy[１.８] for trigeminal neuralgia guided by C-arm or CT scaning to location target of ovale foramen. Methods A retrospective analysis the clinical date of 2816 patients with trigeminal neuralgia treated using radiofrequency rhizotomy guided by C-arm or CT scanning to location target of trigeminal ganglion. The 65-75℃ temperature and setting time 30-60s can be used. The procedure and complications were evaluated and analysed in this paper .Results: Pain disappeared completely in 2661 cases(96.41%); failled in 39 cases ( 1.4%) , recurrence in 192 cases ( 6.9%) during 2 years post-operatively .Conclusion C-arm or CT-guided selective gasserian radiofrequency rhizotomy for treatment of trigeminal neuralgia showed minimally invasive and safe. Especially elder patient with cardiovascular disease and recurrent cases after MVD could be indicated.

[Key words] C-arm CT scanning; radiofrequency rhizonomy ;trigeminal neuralgia