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脉冲和常规射频治疗:哪种方法对与牙科操作相关的症状性三叉神经痛有效?

Pulsed and conventional radiofrequency treatment: which is effective for dental procedure-related symptomatic trigeminal neuralgia?

机构信息

Anesthesiology and Pain Medicine, Konkuk University Medical Center, Seoul, Korea.

出版信息

Pain Med. 2013 Mar;14(3):430-5. doi: 10.1111/pme.12046. Epub 2013 Feb 22.

DOI:10.1111/pme.12046
PMID:23432997
Abstract

OBJECTIVES

Many patients develop dental treatment-related symptomatic trigeminal neuralgia. However, the effectiveness of pulsed radiofrequency (PRF) treatment and conventional radiofrequency thermocoagulation (RFTC) for treatment of this disorder has not been determined. This retrospective study was conducted to compare the effectiveness and complications of PRF and RFTC in these patients.

METHODS

Fifty-four patients who experienced the onset of symptomatic trigeminal neuralgia after a dental treatment were managed by PRF or RFTC. Data were collected by reviewing their medical records and conducting a questionnaire. Patients' characteristics, the dental procedures that caused the trigeminal neuralgia, the baseline and posttreatment pain intensities, duration of pain relief, complications, and satisfactions to the treatment were evaluated.

RESULTS

Pain intensities were lower at 1 week (3.0/10 vs 6.4/10), at 1 month (2.5/10 vs 5.9/10), 3 months (2.6/10 vs 5.5/10), 6 months (3.1/10 vs 7.1/10) and 1 year (4.8/10 vs 7.2/10) in the RFTC group (28 patients) than in the PRF group (26 patients) (P < 0.05). The duration of pain relief without medication in the RFTC group (10.8 months) was longer than that in the PRF group (0 months). The incidence of complications in the RFTC group (46.4%) was higher than that in the PRF group (3.8%) (P < 0.05). The RFTC group reported higher satisfaction ratings (3.86/5) than the PRF group (2.19/5) (P < 0.05).

CONCLUSIONS

Although the RFTC group had more complications than the PRF group, most were minor and transient, and the patient satisfaction rate with RFTC was very high. Therefore, RFTC is an effective tool for the treatment of dental procedure-induced trigeminal neuralgia.

摘要

目的

许多患者在接受牙科治疗后会出现与治疗相关的症状性三叉神经痛。然而,脉冲射频(PRF)治疗和传统射频热凝(RFTC)治疗这种疾病的效果尚未确定。本回顾性研究旨在比较 PRF 和 RFTC 治疗这些患者的效果和并发症。

方法

对 54 例因牙科治疗而出现症状性三叉神经痛的患者进行 PRF 或 RFTC 治疗。通过回顾病历和问卷调查收集数据。评估患者的特征、导致三叉神经痛的牙科操作、基线和治疗后疼痛强度、疼痛缓解持续时间、并发症以及对治疗的满意度。

结果

RFTC 组(28 例)患者在治疗后 1 周(3.0/10 比 6.4/10)、1 个月(2.5/10 比 5.9/10)、3 个月(2.6/10 比 5.5/10)、6 个月(3.1/10 比 7.1/10)和 1 年(4.8/10 比 7.2/10)时的疼痛强度均低于 PRF 组(26 例)(P<0.05)。RFTC 组(10.8 个月)无药物治疗的疼痛缓解持续时间长于 PRF 组(0 个月)。RFTC 组(46.4%)的并发症发生率高于 PRF 组(3.8%)(P<0.05)。RFTC 组的满意度评分(3.86/5)高于 PRF 组(2.19/5)(P<0.05)。

结论

尽管 RFTC 组的并发症多于 PRF 组,但大多数为轻微且短暂的,且患者对 RFTC 的满意度非常高。因此,RFTC 是治疗牙科操作引起的三叉神经痛的有效工具。

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