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经皮球囊压迫术后影响三叉神经痛复发的因素。

Factors that may affect recurrence of trigeminal neuralgia after percutaneous balloon compression.

机构信息

Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Department of Neurosurgery, First People's Hospital of Ningyang County, Tai'an, Shandong, China.

Clinical Medical College, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong, China.

出版信息

J Clin Neurosci. 2022 May;99:248-252. doi: 10.1016/j.jocn.2022.03.022. Epub 2022 Mar 16.

Abstract

OBJECTIVE

To investigate the efficacy of percutaneous balloon compression of the Gasserian Ganglion (PCGG) in the treatment of trigeminal neuralgia(TN)and the influencing factors of recurrence after PCGG.

METHODS

The clinical data of 221 patients with TN treated by PCGG were retrospectively analyzed and followed-up to explore the postoperative efficacy.

RESULTS

There were 158 cases of immediate disappearance of pain and 59 cases of delayed pain disappearance in patients after one PCGG operation, for an overall efficacy rate of 98.2%. Forty-nine patients experienced recurrence of pain, for a recurrence rate of 22.6%, and average recurrence time of 18 months. The effective rate of medication in patients with recurrent trigeminal neuralgia is 85.7%.Univariate and multivariate logistic regression analyses showed that hypertension disease and delayed pain disappearance were independent factors for recurrence. The incidence of inhibitory reaction of the trigeminal nerve during the operation was 97.3%. The most common postoperative complications were facial numbness, masticatory-muscle weakness, tinnitus, diplopia and keratitis, which occurred at rates of 76.9%, 28.1%, 14.5%, 11.8% and 10.4%, respectively. All of the complications resolved within 3 years after PCGG.

CONCLUSIONS

PCGG is a safe and effective surgical method for the treatment of TN. The pain in most patients disappeared after surgery, leaving sequelae such as facial numbness, masticatory-muscle weakness and tinnitus. The mean time to recurrence of postoperative pain was 18 months, with hypertension disease and delayed pain disappearance as associated factors.

摘要

目的

探讨经皮球囊压迫术(PCGG)治疗三叉神经痛(TN)的疗效及影响术后复发的因素。

方法

回顾性分析 221 例 TN 患者行 PCGG 治疗的临床资料并进行随访,探讨术后疗效。

结果

1 次 PCGG 术后即刻疼痛消失 158 例,延迟疼痛消失 59 例,总有效率为 98.2%。49 例患者出现疼痛复发,复发率为 22.6%,平均复发时间为 18 个月。复发三叉神经痛患者药物治疗有效率为 85.7%。单因素及多因素 logistic 回归分析显示,高血压病史和延迟疼痛消失是复发的独立影响因素。术中三叉神经抑制反应发生率为 97.3%。术后常见并发症为面部麻木、咀嚼肌无力、耳鸣、复视和角膜炎,发生率分别为 76.9%、28.1%、14.5%、11.8%和 10.4%,所有并发症均在 PCGG 术后 3 年内缓解。

结论

PCGG 是治疗 TN 的一种安全有效的手术方法,术后大部分患者疼痛消失,遗留面部麻木、咀嚼肌无力、耳鸣等后遗症。术后疼痛复发的平均时间为 18 个月,高血压病史和延迟疼痛消失是相关因素。

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