伽玛刀联合卡马西平治疗原发性三叉神经痛
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摘要
目的探讨伽玛刀联合卡马西平治疗原发性三叉神经痛的方法及效果。方法将192例原发性三叉神经痛患者按随机数字表法分为2组:观察组96例,应用伽玛刀联合卡马西平治疗;对照组96例,单用伽玛刀治疗。治疗后随访3～60个月,平均46个月。比较2组治疗后3个月内有效率、总有效率、无效或复发率、不良反应及并发症。结果治疗后3个月内有效率观察组为81.5%、对照组为33.8%,总有效率观察组为95.8%、对照组为80.2%,2组比较差异均有统计学意义(均P<0.05)。2组患者治疗后均无明显不良反应及并发症。结论应用伽玛刀联合卡马西平治疗原发性三叉神经痛具有显著的临床疗效,且临床使用安全。
Objective To explore the effect of gamma knife surgery combined with carbamazepine on primary trigeminal neuralgia.Methods A total of 192 cases of primary trigeminal neuralgia were randomly treated with gamma knife surgery alone(control group,n=96) or in combination with carbamazepine(observation group,n=96).Patients were followed up for 3-60 months(average 46 months).The obvious effective rate,total effective rate,ineffective rate,relapse rate,adverse reactions and complications were compared between the two groups.Results Within 3 months after treatment,the obvious effective rate and total effective rate in observation group were higher than those in control group(81.5% vs 33.8% and 95.8% vs 80.2%,respectively;P<0.05).No adverse reactions and complications occurred in both groups.Conclusion Gamma knife surgery combined with carbamazepine is effective and safe for treating primary trigeminal neuralgia.
Objective To explore the effect of gamma knife surgery combined with carbamazepine on primary trigeminal neuralgia.Methods A total of 192 cases of primary trigeminal neuralgia were randomly treated with gamma knife surgery alone(control group,n=96) or in combination with carbamazepine(observation group,n=96).Patients were followed up for 3-60 months(average 46 months).The obvious effective rate,total effective rate,ineffective rate,relapse rate,adverse reactions and complications were compared between the two groups.Results Within 3 months after treatment,the obvious effective rate and total effective rate in observation group were higher than those in control group(81.5% vs 33.8% and 95.8% vs 80.2%,respectively;P<0.05).No adverse reactions and complications occurred in both groups.Conclusion Gamma knife surgery combined with carbamazepine is effective and safe for treating primary trigeminal neuralgia.
引文
[1] PATEL S K,LIU J K.Overview and history of trigeminal neuralgia[J].Neurosurg Clin N Am,2016,27(3):265-276.
[2] 王丽娟.奥卡西平和卡马西平治疗原发性三叉神经痛[J].中国实用医刊,2015,42(23):71-72.
[3] DAI D M.Clinical analysis of three different methods for the treatment of primary trigeminal neuralgia[J].Systems Medical,2017,2(19):43-45.
[4] 郭金婉,张建中,宋文阁,等.205例半月神经节射频热凝治疗原发性三叉神经痛的疗效分析[J].中国疼痛医学杂志,2018,24(8):597-602.
[5] 何春雷,杨欣刚,宋传臣.伽玛刀分次治疗原发性三叉神经痛的疗效[J].中国疼痛医学杂志,2017,23(11):855-857.
[6] ROGERS C L,SHETTER A G,FIEDLER J A,et al.Gamma knife radiosurgery for trigeminal neuralgia:the initial experience of the barrow neurological institute[J].Int J Radiat Oncol Biol Phys,2000,47(4):1013-1019.
[7] 程轶峰,刘晓民,李彦和,等.原发性三叉神经痛的再次伽玛刀治疗[J].中国疼痛医学杂志,2014,20(2):81-85.
[8] 王建峰,孟喜君,李晓怡.伽玛刀治疗三叉神经痛201例长期疗效观察[J].陜西医学杂志,2015,44(1):27-28.
[9] 陈延玲.息风通络止痛汤联合卡马西平治疗三叉神经痛疗效观察[J].现代中西医结合杂志,2017,26(15):1632-1634.
[10] 薛庆澄.神经外科学[M].天津:天津科学技术出版社,1990:279.
[11] LEKSELL L.Stereotaxic radiosurgery in trigeminal neuralg-ia[J].Acta Chir Scand,1971,37:311-314.
[12] LINDQUIST C,KIHLSTR?M L,HELLSTRAND E.Functional neurosurgery:a future for the gamma knife?[J].Stereotact Funct Neurosurg,1991,57(1/2):72-81.
[13] RAND R W.Leksell Gamma Knife treatment of tic douloureux[J].Neurosurg Clin N Am,1997,8(1):75-78.
[14] YOUNG R F,VERMULEN S,POSEWITZ A.Gamma knife radiosurgery for the treatment of trigeminal neuralgia[J].Sterotact Funct Neurosurg,1998,70(S 1):192-199.
[15] 吴高峰,雷进,吴娜娜,等.原发性三叉神经痛伽玛刀治疗:附838例分析[J].四川医学,2016,37(3):296-298.
[16] 徐秀理,卢虎生,胡宗涛,等.国内伽玛刀与手术治疗三叉神经痛疗效的Meta分析[J].安徽医药,2017,21(11):2042-2045.
[2] 王丽娟.奥卡西平和卡马西平治疗原发性三叉神经痛[J].中国实用医刊,2015,42(23):71-72.
[3] DAI D M.Clinical analysis of three different methods for the treatment of primary trigeminal neuralgia[J].Systems Medical,2017,2(19):43-45.
[4] 郭金婉,张建中,宋文阁,等.205例半月神经节射频热凝治疗原发性三叉神经痛的疗效分析[J].中国疼痛医学杂志,2018,24(8):597-602.
[5] 何春雷,杨欣刚,宋传臣.伽玛刀分次治疗原发性三叉神经痛的疗效[J].中国疼痛医学杂志,2017,23(11):855-857.
[6] ROGERS C L,SHETTER A G,FIEDLER J A,et al.Gamma knife radiosurgery for trigeminal neuralgia:the initial experience of the barrow neurological institute[J].Int J Radiat Oncol Biol Phys,2000,47(4):1013-1019.
[7] 程轶峰,刘晓民,李彦和,等.原发性三叉神经痛的再次伽玛刀治疗[J].中国疼痛医学杂志,2014,20(2):81-85.
[8] 王建峰,孟喜君,李晓怡.伽玛刀治疗三叉神经痛201例长期疗效观察[J].陜西医学杂志,2015,44(1):27-28.
[9] 陈延玲.息风通络止痛汤联合卡马西平治疗三叉神经痛疗效观察[J].现代中西医结合杂志,2017,26(15):1632-1634.
[10] 薛庆澄.神经外科学[M].天津:天津科学技术出版社,1990:279.
[11] LEKSELL L.Stereotaxic radiosurgery in trigeminal neuralg-ia[J].Acta Chir Scand,1971,37:311-314.
[12] LINDQUIST C,KIHLSTR?M L,HELLSTRAND E.Functional neurosurgery:a future for the gamma knife?[J].Stereotact Funct Neurosurg,1991,57(1/2):72-81.
[13] RAND R W.Leksell Gamma Knife treatment of tic douloureux[J].Neurosurg Clin N Am,1997,8(1):75-78.
[14] YOUNG R F,VERMULEN S,POSEWITZ A.Gamma knife radiosurgery for the treatment of trigeminal neuralgia[J].Sterotact Funct Neurosurg,1998,70(S 1):192-199.
[15] 吴高峰,雷进,吴娜娜,等.原发性三叉神经痛伽玛刀治疗:附838例分析[J].四川医学,2016,37(3):296-298.
[16] 徐秀理,卢虎生,胡宗涛,等.国内伽玛刀与手术治疗三叉神经痛疗效的Meta分析[J].安徽医药,2017,21(11):2042-2045.