Lin Yanda, Ni Jiaxiang, Zuo Xinlu, Yang Liqiang, He Liangliang, Tang Yuanzhang, Sun Chengli
Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Nursing, Chengde Nursing Vocational College, Chengde, China.
Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):620-624. doi: 10.5114/wiitm.2020.92409. Epub 2020 Jan 19.
Postoperative facial numbness is the main complication of radiofrequency thermocoagulation in treating trigeminal neuralgia, which could seriously affect the surgical efficacy. This problem is expected to be resolved by coblation technique.
To compare the long-term efficacy and safety of coblation and percutaneous trigeminal radiofrequency thermocoagulation (PT-RFT) under fluoroscopic guidance in the treatment of trigeminal neuralgia (TN).
A case-control prospective study was carried out. Patients with TN were randomly scheduled to receive coblation or PT-RFT. Both surgical procedures were performed under fluoroscopic guidance. The data, including the degree of pain, pain relief and complications, were recorded during follow-up evaluation, which was performed on the first day and at the end of the first month, third month, sixth month and first year after surgery.
A total of 50 patients were enrolled in this study, with 25 patients in each group. The visual analog scale (VAS) scores in both groups at each time point after surgery were significantly lower compared with before surgery (p < 0.05). There were no significant differences in VAS scores or pain relief between the two groups at any time point after surgery (p > 0.05). However, patients in the PT-RFT group exhibited greater facial numbness after surgery (p < 0.05). For other complications, there were no significant differences between the two groups (p > 0.05).
Coblation and PT-RFT showed similar effectiveness in reducing pain; however, coblation was associated with a lower rate of postoperative facial numbness. Therefore, coblation may be a better treatment option for TN.
术后面部麻木是射频热凝治疗三叉神经痛的主要并发症,可严重影响手术疗效。这一问题有望通过低温等离子技术得到解决。
比较低温等离子和经皮三叉神经射频热凝术(PT-RFT)在X线透视引导下治疗三叉神经痛(TN)的长期疗效和安全性。
进行一项病例对照前瞻性研究。TN患者被随机安排接受低温等离子或PT-RFT治疗。两种手术均在X线透视引导下进行。在术后第1天、第1个月、第3个月、第6个月和第1年末进行随访评估时记录数据,包括疼痛程度、疼痛缓解情况和并发症。
本研究共纳入50例患者,每组25例。两组术后各时间点的视觉模拟评分(VAS)均显著低于术前(p < 0.05)。术后两组在任何时间点的VAS评分或疼痛缓解情况均无显著差异(p > 0.05)。然而,PT-RFT组患者术后面部麻木更严重(p < 0.05)。对于其他并发症,两组之间无显著差异(p > 0.05)。
低温等离子和PT-RFT在减轻疼痛方面显示出相似的效果;然而,低温等离子术后面部麻木发生率较低。因此,低温等离子可能是TN更好的治疗选择。