Zhao W-X, Wang Q, He M-W, Yang L-Q, Wu B-S, Ni J-X
Department of Pain Management, Xuanwu Medical University, Xuanwu, Beijing, China.
Department of Pain Management, Xuanwu Medical University, Xuanwu, Beijing, China
Genet Mol Res. 2015 Jul 13;14(3):7616-23. doi: 10.4238/2015.July.13.5.
Trigeminal neuralgia is a sudden, severe condition characterized by stabbing and recurrent pain. Radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) are common surgical interventions used to treat trigeminal neuralgia. This study aimed to investigate the therapeutic effects and associated complications of a combination of RFT and PRF in the treatment of trigeminal neuralgia. Computed tomography-guided percutaneous RFT of the Gasserian ganglion was performed on 80 patients with trigeminal neuralgia. Patients were randomly assigned to either group A (RFT at 70°C) or group B (RFT at 75°C). Patients in each group were divided into 2 subgroups, receiving percutaneous RFT (240 s) with or without PRF (42°C, 2 Hz, 240 s). Six months later, pain relief and complication status were evaluated. There was no significant difference in visual analogue scores among groups with RFT at 70° or 75°C, with or without PRF. Data showed that facial numbness and postoperative masticatory muscle weakness recovered more rapidly in patients receiving combined RFT and PRF treatment. Decreased corneal reflex was relieved to a significantly greater extent in groups receiving PRF than those without. Thus, compared to the use of RFT at 75°C alone, the combination of PRF and RFT helped eliminate postoperative complications, such as facial numbness, masticatory muscle weakness, and decreased corneal reflex, indicating that it could be useful for surgically treating trigeminal neuralgia.
三叉神经痛是一种以刺痛和反复发作的疼痛为特征的突发性严重疾病。射频热凝术（RFT）和脉冲射频（PRF）是用于治疗三叉神经痛的常见外科干预措施。本研究旨在探讨RFT与PRF联合治疗三叉神经痛的疗效及相关并发症。对80例三叉神经痛患者进行了计算机断层扫描引导下的半月神经节经皮RFT治疗。患者被随机分为A组（70°C射频热凝）或B组（75°C射频热凝）。每组患者再分为2个亚组，分别接受有或无PRF（42°C，2Hz，240s）的经皮RFT（240s）治疗。6个月后，评估疼痛缓解情况和并发症状态。在70°或75°C进行射频热凝且有或无PRF的组之间，视觉模拟评分无显著差异。数据显示，接受RFT与PRF联合治疗的患者面部麻木和术后咀嚼肌无力恢复得更快。接受PRF治疗的组角膜反射减弱的缓解程度明显大于未接受PRF治疗的组。因此，与单独使用75°C的射频热凝相比，PRF与RFT联合使用有助于消除术后并发症，如面部麻木、咀嚼肌无力和角膜反射减弱，表明其可用于三叉神经痛的手术治疗。
