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中华脑科疾病与康复杂志(电子版) ›› 2020, Vol. 10 ›› Issue (05) : 272 -275. doi: 10.3877/cma.j.issn.2095-123X.2020.05.004

所属专题: 文献

颅神经疾患

经皮穿刺球囊压迫术治疗肿瘤源性三叉神经痛的疗效分析
王全才1, 马逸1, 黄海韬1, 王斌1, 杨大伟1, 李岩峰1,()   
  1. 1. 110013 沈阳,辽宁省人民医院神经外科
  • 收稿日期:2020-07-05 出版日期:2020-10-15
  • 通信作者: 李岩峰

Analysis of the effect of percutaneous balloon compression on trigeminal neuralgia caused by tumor

Quancai Wang1, Yi Ma1, Haitao Huang1, Bin Wang1, Dawei Yang1, Yanfeng Li1,()   

  1. 1. Department of Neurosurgery, The People’s Hospital of Liaoning Province, Shenyang 110013, China
  • Received:2020-07-05 Published:2020-10-15
  • Corresponding author: Yanfeng Li
引用本文:

王全才, 马逸, 黄海韬, 王斌, 杨大伟, 李岩峰. 经皮穿刺球囊压迫术治疗肿瘤源性三叉神经痛的疗效分析[J]. 中华脑科疾病与康复杂志(电子版), 2020, 10(05): 272-275.

Quancai Wang, Yi Ma, Haitao Huang, Bin Wang, Dawei Yang, Yanfeng Li. Analysis of the effect of percutaneous balloon compression on trigeminal neuralgia caused by tumor[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(05): 272-275.

目的

探讨经皮穿刺球囊压迫术(PBC)治疗肿瘤源性三叉神经痛(TN)的疗效。

方法

回顾性分析辽宁省人民医院神经外科自2005年1月至2017年5月行PBC治疗的72例继发性TN患者的临床资料,评估患者术后的短期和长期的疼痛控制情况和并发症情况。

结果

短期结果:疼痛完全缓解69例,部分缓解3例;术后面部麻木63例,角膜反射减弱7例,感觉异常但可忍受2例,脑脊液漏1例,角膜炎1例,疱疹2例。失访患者32例,可随访患者40例,平均随访72.1个月(范围10~162个月),其中2例死亡。随访结果:远期疼痛完全缓解28例,部分缓解5例,复发5例,并发症包括面部麻木19例,其中7例较术后无明显变化,12例已经明显减轻或局部麻木,脑脊液漏1例,较前减轻,偶尔会有脑脊液渗出,感觉异常难以忍受1例。

结论

PBC是一种简单、安全及有效的治疗方法,针对部分肿瘤源性TN患者,能够起到对开颅手术的有益的补充。

Objective

To investigate the effect of percutaneous balloon compression (PBC) in the treatment of neoplastic trigeminal neuralgia (TN).

Methods

The clinical data of 72 patients with secondary TN treated with PBC in the Department of Neurosurgery of The People’s Hospital of Liaoning Province from January 2005 to May 2017 were retrospectively analyzed, and the short-term and long-term pain control and complications were evaluated.

Results

In the short-term, the clinical outcomes were 69 complete pain-free and 3 partial pain-free, and the complications mainly included facial numbness 63 cases, decreased corneal reflex 7 cases, paresthesia but tolerable 2 cases, cerebral spinal fluid leakage 1 case, keratitis 1 case and herpes 2 cases. The median length of clinical follow-up was 72.1 months (range 10-162 months). Forty patients had follow-up information, of which 2 patients died. In the long-term, 28 patients were complete pain-free, 5 patients partial pain-free and 5 patients recurred. The complications contained facial numbness in 19 patients, 7 of whom had no significant change compared with postoperative, 12 of whom had markedly reduced or local numbness, cerebral spinal fluid leakage in 1 patient, who was better than before and fewer fluid flowed occasionally, paresthesia and intolerable in 1 patient.

Conclusion

PBC is a simple, safe and effective method to relieve TN. For some neoplastic TN patients, it can play a benefical supplement for craniotomy.

表1 72例肿瘤源性三叉神经痛患者的基本资料
表2 72例肿瘤源性三叉神经痛患者的疼痛分布区域
表3 胆脂瘤、脑膜瘤和听神经瘤分类对比治疗结果和并发症
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