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老年三叉神经痛患者的治疗结果:经皮球囊压迫与微血管减压术比较。

Outcomes of Treatment for Elderly Patients With Trigeminal Neuralgia: Percutaneous Balloon Compression Versus Microvascular Decompression.

机构信息

Department of Anesthesiology and Pain, Siyang Hospital of Traditional Chinese Medicine, Siyang.

Department of Anesthesiology, Department of Pain, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Nanjing.

出版信息

J Craniofac Surg. 2020 Oct;31(7):e685-e688. doi: 10.1097/SCS.0000000000006544.

Abstract

OBJECTIVE

The study aimed to evaluate the surgical outcomes of percutaneous balloon compression (PBC) and microvascular decompression (MVD) in the treatment of elderly patients with trigeminal neuralgia (TN).

METHODS

A total of 30 patients who underwent PBC surgery (PBC group) and 30 patients who received MVD surgery (MVD group) were included. The treatment efficacy, Barrow Neurological Institute (BNI) pain intensity score, inflammatory response, the rates of complication and recurrence were analyzed respectively.

RESULTS

The total efficacy was 93.33% in the PBC group and 90.00% in the MVD group (P > 0.05), respectively. The pain relief rate was 90.00% and 86.67% after PBC and MVD surgery, respectively (P > 0.05). The levels of IL-1β, TNF-α, and IL-6 were significantly decreased at post-operative 3 days and 5 days compared with pre-operation in the 2 groups (P < 0.05). The post-operative complication rates regarding masticatory muscle weakness and facial numbness in the PBC group were higher than MVD group (P < 0.05). Nevertheless, the incidences of herpes simplex and keratohelcosis were similar between the 2 groups (P > 0.05). The recurrence rates were also similar between the 3 groups (P > 0.05).

CONCLUSION

Percutaneous balloon compression and MVD are effective in the treatment for elderly TN, which can effectively improve the post-operative cure rate of pain prognosis and reduce the inflammatory response. However, PBC is a minimally invasive, safe and effective method for patients in poor general condition and refused treatment with craniotomy.

摘要

目的

本研究旨在评估经皮球囊压迫(PBC)和微血管减压(MVD)治疗老年三叉神经痛(TN)患者的手术效果。

方法

共纳入 30 例行 PBC 手术的患者(PBC 组)和 30 例行 MVD 手术的患者(MVD 组)。分别分析两组的治疗效果、巴罗神经研究所(BNI)疼痛强度评分、炎症反应、并发症和复发率。

结果

PBC 组的总有效率为 93.33%,MVD 组为 90.00%(P>0.05)。PBC 和 MVD 手术后疼痛缓解率分别为 90.00%和 86.67%(P>0.05)。与术前相比,两组术后 3 天和 5 天的 IL-1β、TNF-α 和 IL-6 水平均显著降低(P<0.05)。PBC 组术后咀嚼肌无力和面神经麻木的并发症发生率高于 MVD 组(P<0.05)。然而,两组单纯疱疹和角膜溃疡的发生率相似(P>0.05)。三组的复发率也相似(P>0.05)。

结论

PBC 和 MVD 对老年 TN 均有效,可有效提高术后疼痛缓解率和改善预后,降低炎症反应。然而,对于一般情况较差且拒绝开颅治疗的患者,PBC 是一种微创、安全且有效的方法。

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