Dyna-CT引导下经皮穿刺三叉神经半月节微球囊压迫术治疗三叉神经痛
|
摘要
目的探讨Dyna-CT引导下经皮穿刺三叉神经节微球囊压迫术(PBC)治疗三叉神经痛的临床效果。方法对2017年9月至2018年11月采用Dyna-CT引导下PBC治疗的17例三叉神经痛的临床资料进行回顾性分析。在Dyna-CT引导下穿刺,颅底3D-CT重建证实穿刺针抵达卵圆孔。通过穿刺针将带导丝CTZ-14球囊导入Meckel腔,球囊压迫三叉神经半月节。结果住院时间3～9 d,平均5.6 d。术后随访6～12个月。术后症状完全消失14例,明显缓解2例,无缓解1例;总有效率为94.2%(16/17)。术后出现面部麻木15例、咀嚼略乏力9例、眼角干涩2例、口角疱疹5例,均经治疗后痊愈。结论 Dyna-CT引导下PBC,是针对复发三叉神经痛、高龄、不愿或不能耐受开颅手术的三叉神经痛的有效微创手术方法,具有良好的临床应用价值。
Objective To explore the clinical curative effects of percutaneous micro-balloon compression(PMBC) of trigeminal ganglion on trigeminal neuralgia under guidance of Dyna CT. Methods The clinical data of 17 patients with trigeminal neuralgia, who underwent PMBC of the trigeminal ganglia under guidance of Dyna CT from September, 2017 to November 2018, were analyzed retrospectively. All the patients were followed up from 6 to 12 months. Results The patients were hospitalized for 3～9 days(mean, 5.6 days). The symptoms completely disappeared in 14 patients(82.4%), significantly relieved in 2(11.8%) and unchanged in 1(5.9%) after the operation. The postoperative complication includeds facial numbness in 15 patients, slightly chewing in 9, dry eyes in 2 and oral herpes in 5. Conclusions Dyna CT-guided PMBC of the trigeminal ganglion is an effective and minimally invasive method to treat the trigeminal neuralgia and it is proper for the elderly patients with trigeminal neuralgia and the patients who have recurrent trigeminal neuralgia are unwilling or unable to tolerate craniotomy.
Objective To explore the clinical curative effects of percutaneous micro-balloon compression(PMBC) of trigeminal ganglion on trigeminal neuralgia under guidance of Dyna CT. Methods The clinical data of 17 patients with trigeminal neuralgia, who underwent PMBC of the trigeminal ganglia under guidance of Dyna CT from September, 2017 to November 2018, were analyzed retrospectively. All the patients were followed up from 6 to 12 months. Results The patients were hospitalized for 3～9 days(mean, 5.6 days). The symptoms completely disappeared in 14 patients(82.4%), significantly relieved in 2(11.8%) and unchanged in 1(5.9%) after the operation. The postoperative complication includeds facial numbness in 15 patients, slightly chewing in 9, dry eyes in 2 and oral herpes in 5. Conclusions Dyna CT-guided PMBC of the trigeminal ganglion is an effective and minimally invasive method to treat the trigeminal neuralgia and it is proper for the elderly patients with trigeminal neuralgia and the patients who have recurrent trigeminal neuralgia are unwilling or unable to tolerate craniotomy.
引文
[1] Mullan S, lichtor T. Percutaneous microcompression of thetrige minal ganglion for trige minal neuralgia[J]. J Neuro-surg, 1983, 59(6):1007-1012.
[2] Bergenheim AT, Asplund P, Linderoth B. Percutaneous ret-roasserian Balloon compression for trige minal neuralgia:Review of critical technical details and outcomes[J]. J WorldNeurosurg, 2013, 79(3):359-368.
[3] Skirving DJ. Dan NG. A one year review of percutaneousballooncompression of the ftige minal ganglion[J]. J Neuro-surg, 2001, 94:913-917.
[4]俞文华,许陪源,朱强,等.经皮穿刺球囊压迫治疗顽固性三叉神经痛[J].浙江医学,2012,34(16):1333-1335.
[5]张健,施恩标,张文川,等. CT下经皮穿刺半月神经节射频热凝治疗原发性三叉神经痛的临床效果[J].中国医药导报,2018,15(20):112-115.
[6]肖旭阳,董铁立,王春亭,等. CT三维定位下选择性射频热凝治疗原发性三叉神经痛[J].中国疼痛医学杂志,2014,20(7):524-525.
[7]俞文华.影响经皮穿刺球囊压迫术治疗三叉神经痛疗效的因素[J].实用医学杂志,2014,30(21):3379-3380.
[8]邹建军,马逸,王斌,等.高危原发性三叉神经痛的介入治疗[J].介入放射学杂志,2008,17(8):592-594.
[9] Montano N, Papacci F, Cioni B, et al. The role of percuta-neous balloon compression in the treatment of trige minalneuralgia recurring after other surgical procedures[J]. ActaNeurol Belg, 2014, 114(1):59-64.
[10] Cheng JS, Lim DA, Chang EF, et al. A review of percuta-neous treatments for trige minal neuralgia[J]. Neurosurgery,2014, 10(1):25-33.
[2] Bergenheim AT, Asplund P, Linderoth B. Percutaneous ret-roasserian Balloon compression for trige minal neuralgia:Review of critical technical details and outcomes[J]. J WorldNeurosurg, 2013, 79(3):359-368.
[3] Skirving DJ. Dan NG. A one year review of percutaneousballooncompression of the ftige minal ganglion[J]. J Neuro-surg, 2001, 94:913-917.
[4]俞文华,许陪源,朱强,等.经皮穿刺球囊压迫治疗顽固性三叉神经痛[J].浙江医学,2012,34(16):1333-1335.
[5]张健,施恩标,张文川,等. CT下经皮穿刺半月神经节射频热凝治疗原发性三叉神经痛的临床效果[J].中国医药导报,2018,15(20):112-115.
[6]肖旭阳,董铁立,王春亭,等. CT三维定位下选择性射频热凝治疗原发性三叉神经痛[J].中国疼痛医学杂志,2014,20(7):524-525.
[7]俞文华.影响经皮穿刺球囊压迫术治疗三叉神经痛疗效的因素[J].实用医学杂志,2014,30(21):3379-3380.
[8]邹建军,马逸,王斌,等.高危原发性三叉神经痛的介入治疗[J].介入放射学杂志,2008,17(8):592-594.
[9] Montano N, Papacci F, Cioni B, et al. The role of percuta-neous balloon compression in the treatment of trige minalneuralgia recurring after other surgical procedures[J]. ActaNeurol Belg, 2014, 114(1):59-64.
[10] Cheng JS, Lim DA, Chang EF, et al. A review of percuta-neous treatments for trige minal neuralgia[J]. Neurosurgery,2014, 10(1):25-33.