原发性三叉神经痛三种不同治疗方法的临床疗效分析

发布时间：2018-02-11 20:59

本文关键词： 原发性三叉神经痛微血管减压术伽玛刀射频热凝　出处：《浙江大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：比较微血管减压术(MVD)、伽玛刀(GKS)和射频热凝术(RF)治疗原发性三叉神经痛(PTN)的疗效、并发症等特点,探讨不同方法治疗PTN的预后。方法：自2010年6月至2013年6月收治的原发性三叉神经痛患者63例,其中18例行微血管减压术治疗,24例行伽玛刀放射治疗。21例行射频热凝术治疗。术后随访,对比分析治疗后的疗效、并发症发生情况。结果： MVD组18人,术后1周,3,6,12个月及末次随访时疼痛累积缓解率分别为88.9%,94.4%,94.4%,94.4%,94.4%；GKS组24人,术后1周,3,6,12个月及末次随访时疼痛累积缓解率分别为20.8%,54.2%,79.2%,87.5%,87.5%；RF组21人,术后1周,3,6,12个月及末次随访时疼痛累积缓解率分别85.7%,90.5%,90.5%,85.7%,81.0%;其中术后1周及3月疼痛累积缓解率GKS组显著低于其他两组(P0.05),其他时间段无显著性差异；1年内复发率MVD组,GKS组和RF组分别为0%,4.2%,9.5%,三者无显著性差异；长期并发症发生率MVD组,GKS组和RF组分别为0%,4.2%,71.4%,RF组显著高于其他两组(P0.05)。结论：三种方法治疗PTN均有效果,对于可以耐受手术的患者,MVD是首选治疗。GKS起效时间较慢,RF并发症发生率高,对于有手术禁忌或拒绝手术者,两者是不错的选择。
[Abstract]:Objective: to compare the effects and complications of microvascular decompression and radiofrequency thermocoagulation (RF) in the treatment of primary trigeminal neuralgia (PTN), and to explore the prognosis of different methods in the treatment of PTN. Methods: from June 2010 to June 2013, 63 cases of primary trigeminal neuralgia were treated. Among them, 18 cases were treated with microvascular decompression, 24 cases with gamma knife radiotherapy and 21 cases with radiofrequency thermocoagulation. The curative effect and complications after treatment were compared and analyzed. Results: the cumulative pain relief rates of 18 patients in the MVD group at 3 weeks, 12 months and the last follow-up were 88.9% and 94.44%, respectively. The cumulative relief rates of pain in the first week, 12 months and the last follow-up were 20.84.29.2and 87.57.5RF, respectively. The cumulative relief rate of pain was 85.7% at the first week after 1 week, at 12 months and at the last follow-up. The cumulative relief rate of pain in the GKS group was significantly lower than that in the other two groups at 1 week and March, and there was no significant difference in the recurrence rate within one year in the MVD group and the GKS group in the first week after operation and on March, and the cumulative relief rate of pain in the GKS group was significantly lower than that in the other two groups (P 0.05), and there was no significant difference in other periods of time. There was no significant difference among the three groups (P < 0.05). The incidence of long-term complications in MVD group was significantly higher than that in the other two groups (P 0.05). Conclusion: all the three methods are effective in the treatment of PTN. For the patients who can tolerate the operation, the first choice is the first treatment. The onset time of GKS is higher than that of the slow onset and the incidence of RF complications is higher. The two methods are good choices for those who have surgery taboos or reject the operation.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R745.11

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