微血管减压术与伽玛刀手术治疗药物难治性三叉神经痛的疗效比较：系统评价与荟萃分析。
Microvascular Decompression Versus Gamma Knife Surgery in Patients with Drug-Resistant Trigeminal Neuralgia: A Systematic Review and Meta-Analysis.
机构信息
Tehran University of Medical Sciences, Tehran, Iran.
Urmia University of Medical Sciences, Urmia, Iran.
出版信息
World Neurosurg. 2022 Nov;167:67-73. doi: 10.1016/j.wneu.2022.08.020. Epub 2022 Aug 13.
OBJECTIVE
There are 2 cardinal approaches for drug-resistant trigeminal neuralgia (TN), including microvascular decompression (MVD) and gamma knife surgery (GKS). This study aimed to compare the results of MVD versus GKS in the treatment of drug-resistant TN.
METHODS
The search strategy was formulated in accordance with PRISMA recommendations for publications retrieved from electronic databases, such as PubMed, Scopus, and web of science. Inclusion and exclusion criteria were examined for relevant research. The meta-analysis was conducted by combining data using odds ratios.
RESULTS
Four papers were included in our study. 582 patients were treated with MVD, and 607 patients were treated with GKS for drug-resistant TN. Findings revealed that MVD related to higher rates of pain relief and lower rates of pain recurrence compared to GKS. It seems that GKS had lower post-procedural complications in our review.
CONCLUSIONS
MVD and GKS both reduce pain in patients with drug-resistant TN, but MVD was superior to GKS in pain relief. Furthermore, recurrence rate was lower. Post-operative complications except facial numbness were higher in MVD.
目的
治疗药物难治性三叉神经痛（TN）有两种主要方法，包括微血管减压术（MVD）和伽玛刀手术（GKS）。本研究旨在比较 MVD 与 GKS 治疗药物难治性 TN 的效果。
方法
根据 PRISMA 建议，制定了从电子数据库（如 PubMed、Scopus 和 Web of Science）检索文献的搜索策略。对相关研究进行了纳入和排除标准的检查。使用优势比合并数据进行了荟萃分析。
结果
本研究纳入了 4 篇论文。582 例患者接受 MVD 治疗，607 例患者接受 GKS 治疗药物难治性 TN。研究结果表明，与 GKS 相比，MVD 与更高的疼痛缓解率和更低的疼痛复发率相关。在我们的综述中，GKS 的术后并发症似乎较低。
结论
MVD 和 GKS 均可减轻药物难治性 TN 患者的疼痛，但 MVD 在缓解疼痛方面优于 GKS。此外，复发率较低。MVD 的术后并发症除面部麻木外，均高于 GKS。
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