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计算机断层扫描引导下蝶腭神经节脉冲射频治疗16例难治性丛集性头痛患者:12至30个月的随访评估

Computerized tomography-guided sphenopalatine ganglion pulsed radiofrequency treatment in 16 patients with refractory cluster headaches: Twelve- to 30-month follow-up evaluations.

作者信息

Fang Luo, Jingjing Lu, Ying Shen, Lan Meng, Tao Wang, Nan Ji

机构信息

Department of Anesthesiology and Pain Management, Beijing Tiantan Hospital, Capital Medical University, China.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China.

出版信息

Cephalalgia. 2016 Feb;36(2):106-12. doi: 10.1177/0333102415580113. Epub 2015 Apr 20.

Abstract

BACKGROUND

Sphenopalatine ganglion percutaneous radiofrequency thermocoagulation treatment can improve the symptoms of cluster headaches to some extent. However, as an ablation treatment, radiofrequency thermocoagulation treatment also has side effects.

OBJECTIVE

To preliminarily evaluate the efficacy and safety of a non-ablative computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion in patients with refractory cluster headaches.

METHODS

We included and analysed 16 consecutive cluster headache patients who failed to respond to conservative therapy from the Pain Management Center at the Beijing Tiantan Hospital between April 2012 and September 2013 treated with pulsed radiofrequency treatment of sphenopalatine ganglion.

RESULTS

Eleven of 13 episodic cluster headaches patients and one of three chronic cluster headaches patient were completely relieved of the headache within an average of 6.3 ± 6.0 days following the treatment. Two episodic cluster headache patients and two chronic cluster headache patients showed no pain relief following the treatment. The mean follow-up time was 17.0 ± 5.5 months. All patients enrolled in this study showed no treatment-related side effects or complications.

CONCLUSION

Our data show that patients with refractory episodic cluster headaches were quickly, effectively and safely relieved from the cluster period after computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion, suggesting that it may be a therapeutic option if conservative treatments fail.

摘要

背景

蝶腭神经节经皮射频热凝治疗可在一定程度上改善丛集性头痛症状。然而,作为一种消融治疗,射频热凝治疗也有副作用。

目的

初步评估计算机断层扫描引导下非消融性脉冲射频治疗蝶腭神经节对难治性丛集性头痛患者的疗效和安全性。

方法

纳入并分析2012年4月至2013年9月期间在北京天坛医院疼痛管理中心接受蝶腭神经节脉冲射频治疗且对保守治疗无效的16例连续丛集性头痛患者。

结果

13例发作性丛集性头痛患者中的11例以及3例慢性丛集性头痛患者中的1例在治疗后平均6.3±6.0天内头痛完全缓解。2例发作性丛集性头痛患者和2例慢性丛集性头痛患者治疗后疼痛未缓解。平均随访时间为17.0±5.5个月。本研究纳入的所有患者均未出现与治疗相关的副作用或并发症。

结论

我们的数据表明,计算机断层扫描引导下脉冲射频治疗蝶腭神经节后,难治性发作性丛集性头痛患者在丛集期可快速、有效且安全地缓解,提示保守治疗无效时这可能是一种治疗选择。

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