小脑裂入路在原发性三叉神经痛手术中的应用研究
发布时间:2018-04-06 04:39
本文选题:原发性三叉神经痛 切入点:微血管减压术 出处:《福建中医药大学》2017年硕士论文
【摘要】:目的:评价小脑裂入路在三叉神经微血管减压术中的应用意义,从中获取更多相关证据及经验,指导临床应用。方法:选取神经外科2012年1月-2013年12月期间行微血管减压术的原发性三叉神经痛病例167例。根据纳入排除标准,共收集到传统枕下乙状窦后入路组(A组)病例53例和小脑裂入路组(B组)病例61例,对比分析两种术式在治疗原发性三叉神经痛中三叉神经根暴露情况、岩静脉阻挡情况、岩静脉烫除情况、责任血管的压迫部位、责任血管类型、术后并发症及术后第1天、第12个月、第24个月、第36个月的疗效,并进行统计分析。结果:A、B组的一般临床资料、疼痛支分布情况差异无统计学意义(P0.05);A、B组术中三叉神经根暴露情况差异有统计学意义(P0.05);A、B组术中岩静脉的阻挡情况差异有统计学意义(P0.05);A、B组术中岩静脉的烫除情况差异有统计学意义(P0.05);A、B组术中责任血管的压迫部位差异无统计学意义(P0.05);A、B组术中责任血管的类型差异无统计学意义(P0.05);A、B组术后岩静脉回流障碍相关的意识障碍差异具有统计学意义(P0.05);A、B组术后其它并发症的差异无统计学意义(P0.05);A、B组术后第1天、第12个月、第24个月疗效差异无统计学意义(P0.05),但术后第36个月A、B组的疗效差异具有统计学意义(P0.05)。结论:小脑裂入路术中不仅可以减少对小脑的牵拉,较好地避开岩静脉,充分利用自然解剖间隙暴露三叉神经根,利于责任血管的发现与减压,而且术后岩静脉回流障碍相关的并发症少和更好的远期疗效。
[Abstract]:Objective: To evaluate the cerebellar fissure approach in the trigeminal nerve micro vascular decompression in the application, to obtain more evidence and experience in clinical practice. Methods: from January 2012 -2013 December Department of neurosurgery during microvascular decompression for primary trigeminal neuralgia patients 167 cases. According to the inclusion and exclusion criteria were collected. The traditional suboccipital retrosigmoid approach group (A group) and 53 cases of cerebellar fissure approach group (B group) 61 cases, comparative analysis of two kinds of surgical procedures in the treatment of primary trigeminal neuralgia in the trigeminal nerve root exposure, petrosal vein blocking, except in cases of hot rock vein, oppression site responsible vessels, vascular type, postoperative complications and first days, twelfth months, twenty-fourth months, thirty-sixth months of treatment, and statistical analysis. Results: A, general clinical data of B group, no significant differences in the distribution of branch pain (P0.05); A, B缁勬湳涓笁鍙夌缁忔牴鏆撮湶鎯呭喌宸紓鏈夌粺璁″鎰忎箟(P0.05);A,B缁勬湳涓博闈欒剦鐨勯樆鎸℃儏鍐靛樊寮傛湁缁熻瀛︽剰涔,
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