Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China.
Pain Physician. 2018 Sep;21(5):E545-E553.
Primary trigeminal neuralgia (TN) is a common clinical refractory neuralgia. Severe pain is experienced during episodes, severely impacting the patient's quality of life. Long-term suffering from the disease can lead to anxiety, depression, and even suicide. The pathological processes involved in TN are complex, the mechanisms of pathogenesis are unknown, and effective treatment is lacking.
This study aimed to assess the efficacy and safety of computed tomography (CT)-guided pulsed radiofrequency (PRF) combined with low-temperature continuous radiofrequency (CRF) thermocoagulation in V2/V3 primary trigeminal neuralgia.
This research used a retrospective comparative study design.
The research took place at Shengjing Hospital of China Medical University.
A total of 80 hospitalized patients with TN were selected between January 2014 and December 2015 and randomly assigned to 2 groups differentiated by therapeutic method: CRF (CRF group, n = 40) and PRF + CRF (PCRF group, n = 40). Radiofrequency therapy was performed under the guidance of CT. Follow-up measures assessed preoperative conditions, pain remission, complications and side effects, recovery time, and recurrence rate over the 2 years following the surgery.
The Visual Analog Scale (VAS) scores decreased in both groups after surgery. After one month, the decrease in the VAS score in the PCRF group was more apparent, and this difference was maintained for 2 years. The total efficiency rates in the CRF and PCRF groups were 85% and 97.5%, respectively, at 6 months, 1 year, and 2 years post-surgery. The differences in total efficiency rate of pain between the 2 groups at 6 months, 1 year, and 2 years were statistically significant. Recovery times in the PCRF group were shorter than those in the CRF group. Specifically, recovery times for facial numbness in the CRF and PCRF groups were 3.12 ± 1.21 months and 2.23 ± 1.02 months, respectively. Recovery times for masticatory muscle weakness were 4.33 ± 1.54 months and 3.42 ± 0.98 months, respectively.
This study is limited by being a retrospective study, and by having a relatively small sample size from a single center.
CT-guided PRF combined with low-temperature CRF thermocoagulation for treating V2/V3 primary TN effectively relieves pain, increases late-stage pain remission rate, reduces complications, and reduces the rate of recurrence.
Complication, continuous radiofrequency thermocoagulation, pulsed radiofrequency, recurrence rate, trigeminal neuralgia, Visual Analog Scale.
原发性三叉神经痛（TN）是一种常见的临床难治性神经痛。发作时会出现剧烈疼痛，严重影响患者的生活质量。长期患病可导致焦虑、抑郁，甚至自杀。TN 的病理过程复杂，发病机制不明，缺乏有效治疗。
本研究旨在评估 CT 引导下脉冲射频（PRF）联合低温连续射频（CRF）热凝治疗 V2/V3 原发性三叉神经痛的疗效和安全性。
本研究采用回顾性对比研究设计。
研究在中国医科大学盛京医院进行。
选取 2014 年 1 月至 2015 年 12 月期间住院的 80 例 TN 患者，按治疗方法分为射频（CRF 组，n = 40）和 PRF+CRF（PCRF 组，n = 40）两组。在 CT 引导下进行射频热凝治疗。术后随访评估术前情况、疼痛缓解、并发症及不良反应、恢复时间及术后 2 年内复发率。
两组术后 VAS 评分均降低。术后 1 个月，PCRF 组 VAS 评分下降更明显，且持续 2 年。术后 6 个月、1 年、2 年时，CRF 组和 PCRF 组的总有效率分别为 85%和 97.5%。两组术后 6 个月、1 年、2 年的疼痛总有效率差异有统计学意义。PCRF 组的恢复时间短于 CRF 组。具体来说，CRF 组和 PCRF 组的面部麻木恢复时间分别为 3.12±1.21 个月和 2.23±1.02 个月，咀嚼肌无力恢复时间分别为 4.33±1.54 个月和 3.42±0.98 个月。
本研究为回顾性研究，且样本量较小，仅来自单一中心。
CT 引导下 PRF 联合低温 CRF 热凝治疗 V2/V3 原发性 TN 可有效缓解疼痛，提高晚期疼痛缓解率，减少并发症，降低复发率。
并发症；连续射频热凝；脉冲射频；复发率；三叉神经痛；视觉模拟评分
