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微血管减压术与经皮球囊压迫术治疗三叉神经痛的疗效和安全性:系统评价和荟萃分析。

Efficacy and safety of microvascular decompression versus percutaneous balloon compression in the treatment of trigeminal neuralgia: a systematic review and meta-analysis.

机构信息

Department of Radiology, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.

Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.

出版信息

Ann Palliat Med. 2022 Apr;11(4):1391-1400. doi: 10.21037/apm-21-3901.

Abstract

BACKGROUND

Trigeminal neuralgia (TN) is a type of transient and paroxysmal recurrent severe pain confined to the trigeminal nerve region. This study systematically evaluated the efficacy and safety of microvascular decompression (MVD) and percutaneous balloon compression (PBC) in the treatment of TN.

METHODS

PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Weipu databases were searched for articles published on the use of MVD and PBC in the treatment of TN from the dates of inception of the databases to October 2019. Articles on MVD and PBC in the treatment of TN were selected, and a meta-analysis was performed using RevMan 5.2 software.

RESULTS

Eighteen studies (comprising 1,932 patients) were included in the study. MVD and PBC had similar overall effective rates in treating TN [odds ratio (OR) =0.79, 95% confidence interval (CI): 0.55-1.13, P=0.19]. Patients treated with PBC had a higher recurrence rate of TN than those treated MVD (OR =3.50, 95% CI: 2.25-5.44; P<0.00001), and patients treated with PBC experienced more adverse reactions than those treated with MVD (OR =17.79, 95% CI: 10.17-31.11; P<0.00001).

DISCUSSION

The overall effective rates of PBC and MVD in the treatment of TN ewer similar, but MVD was associated with better recurrence and a lower rate of adverse reactions. Thus, both MVD and PBC can be used to effectively treat TN patients.

摘要

背景

三叉神经痛(TN)是一种局限于三叉神经区域的短暂性和阵发性反复发作的剧烈疼痛。本研究系统评价微血管减压术(MVD)和经皮球囊压迫术(PBC)治疗 TN 的疗效和安全性。

方法

检索 PubMed、Embase、The Cochrane Library、中国知网、万方和维普数据库,从各数据库建库日期至 2019 年 10 月,搜集关于 MVD 和 PBC 治疗 TN 的研究,筛选出关于 MVD 和 PBC 治疗 TN 的文献,采用 RevMan 5.2 软件进行 Meta 分析。

结果

纳入 18 项研究(共 1932 例患者)。MVD 和 PBC 治疗 TN 的总体有效率相似[比值比(OR)=0.79,95%置信区间(CI):0.55-1.13,P=0.19]。PBC 组 TN 复发率高于 MVD 组(OR =3.50,95% CI:2.25-5.44;P<0.00001),PBC 组不良反应发生率高于 MVD 组(OR =17.79,95% CI:10.17-31.11;P<0.00001)。

讨论

PBC 和 MVD 治疗 TN 的总体有效率相似,但 MVD 复发率低,不良反应发生率低。因此,MVD 和 PBC 均可有效治疗 TN 患者。

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