Byvaltsev V A, Kalinin A A, Okoneshnikova A K, Egorov A V, Goloborodko V Yu, Satardinova E E, Biryuchkov M Yu
Irkutsk State Medical University, Irkutsk, Russia.
Clinical Hospital Russian Railways-Medicine, Irkutsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(4):38-43. doi: 10.17116/jnevro202112104138.
To compare the clinical efficacy of laser and radiofrequency denervation in patients with primary trigeminal neuralgia.
The study included 50 patients with primary trigeminal neuralgia who were operated on by laser (group I, =25) or radiofrequency denervation (group II, =25) in the period from 2018 to 2019. To assess the clinical efficacy, we analyzed the dynamics of the pain syndrome level according to the scale of facial pain and the quality of life according to the Short Form Medical Outcomes Study (SF-36), as well as patient satisfaction with the operation according to the Macnab scale, the presence of postoperative surgical complications and adverse effects of anesthesia.
In the postoperative period, according to the scale of facial pain, a decrease in its intensity was noted in both study groups (<0.001). Comparative analysis showed a comparable level of pain in the early postoperative period: at discharge (=0.43) and 6 months after surgery (=0.07). At the same time, after 12 months, lower scores on the scale of facial pain were noted in patients of group I (=0.02). According to SF-36, a significant improvement in the physical and psychological components of health was determined in group I (<0.001) and group II (<0.05). Comparison of SF-36 scores in the long-term postoperative period revealed the best indicators in group I (=0.02 and =0.01, respectively). Comparative analysis verified a greater subjective satisfaction with the operation in group I, compared with group II (<0.001). A comparable number of adverse effects of anesthesia was determined in both groups. Comparative analysis revealed a significantly greater number of postoperative surgical complications in group II (=0.0017).
Laser denervation and radiofrequency denervation are highly effective methods of minimally invasive treatment of primary trigeminal neuralgia.
比较激光和射频去神经术治疗原发性三叉神经痛患者的临床疗效。
本研究纳入了50例原发性三叉神经痛患者，他们于2018年至2019年期间接受了激光治疗（第一组，n = 25）或射频去神经术治疗（第二组，n = 25）。为评估临床疗效，我们根据面部疼痛量表分析了疼痛综合征水平的动态变化，根据简短健康调查量表（SF - 36）分析了生活质量，以及根据Macnab量表分析了患者对手术的满意度、术后手术并发症的存在情况和麻醉的不良反应。
术后，根据面部疼痛量表，两个研究组的疼痛强度均有所降低（P < 0.001）。对比分析显示，术后早期疼痛水平相当：出院时（P = 0.43）和术后6个月（P = 0.07）。同时，12个月后，第一组患者的面部疼痛量表得分较低（P = 0.02）。根据SF - 36，第一组（P < 0.001）和第二组（P < 0.05）的健康身体和心理成分均有显著改善。术后长期SF - 36评分的比较显示，第一组的指标更佳（分别为P = 0.02和P = 0.01）。对比分析证实，与第二组相比，第一组患者对手术的主观满意度更高（P < 0.001）。两组麻醉不良反应的数量相当。对比分析显示，第二组的术后手术并发症数量明显更多（P = 0.0017）。
激光去神经术和射频去神经术是原发性三叉神经痛微创治疗的高效方法。
