微血管减压术治疗原发性三叉神经痛术中岩静脉的处理

发布时间：2019-02-16 14:22

【摘要】：[目的]观察三叉神经痛微血管减压术中岩静脉的形态特点及其对术野暴露的影响,探讨三叉神经痛微血管减压术中对岩静脉及其分支的处理及对预后的影响。[方法]回顾性分析2013年9月至2015年9月昆明医科大学第一附属医院经微血管减压术治疗原发性三叉神经痛62例患者的临床资料,包括患者的临床特征、岩静脉和其属支与手术入路的关系、电凝切断情况及术后并发症。统计分析患者术中岩静脉不同处理方案对于术后不良反应发生率的影响,总结微血管减压术中岩静脉的处理方法。[结果]62例原发性三叉神经痛患者中均发现岩静脉,其中岩静脉的主干阻挡入路16例(25.8%),电凝切断7例(11.3%),岩静脉的属支阻挡入路29例(46.8%),电凝切断14例(22.3%),岩静脉及其属支作为责任血管7例(11.3%),电凝切断3(3.3%),10例(16.1%)岩静脉未阻挡手术入路,均未切断。本组病例中岩静脉电凝切断24例,其中听力下降5例,面部麻木2例,小脑出血性梗死1例：岩静脉未切断38例,听力下降3例,面部麻木2例。[结论]岩静脉为颅后窝重要的引流静脉,与三叉神经关系密切,故在微血管减压术治疗原发性三叉神经痛手术过程中,岩静脉常成为阻障手术入路的路障静脉,影响术野的暴露,阻障手术的操作。因此岩静脉的处理是术中重要的操作环节,同是也是减少术后严重并发症的重要环节。
[Abstract]:[objective] to observe the morphological features of the petrosal vein and its influence on the exposure of the surgical field during microvascular decompression of trigeminal neuralgia, and to explore the effect of microvascular decompression of trigeminal neuralgia on the treatment of the petrosal vein and its branches and prognosis. [methods] the clinical data of 62 patients with primary trigeminal neuralgia treated by microvascular decompression in the first affiliated Hospital of Kunming Medical University from September 2013 to September 2015 were analyzed retrospectively, including the clinical features of the patients. Relationship between petrosal vein and its branches and operative approach, electrocoagulation and postoperative complications. To analyze the influence of different management schemes of petrosal vein on the incidence of postoperative adverse reactions in patients during microvascular decompression, and summarize the management methods of the vein during microvascular decompression. [results] among 62 patients with primary trigeminal neuralgia, petrosal vein was found in 16 cases (25.8%), electrocoagulation in 7 cases (11.3%), branch obstruction in 29 cases (46.8%). There were 14 cases (22.3%) with electrocoagulation, 7 cases (11.3%) with petrosal vein and their branches as responsible vessels, 3 cases (3.3%) with electric coagulation, and 10 cases (16.1%) with no obstruction of petrosal vein. Among the 24 cases, 5 cases were hearing loss, 2 cases were facial numbness, 1 case was cerebellar hemorrhagic infarction, 38 cases were not transected from petrosal vein, 3 cases were hearing loss, and 2 cases were facial numbness. [conclusion] the petrosal vein is an important drainage vein in the posterior cranial fossa, which is closely related to the trigeminal nerve. Therefore, in the treatment of primary trigeminal neuralgia by microvascular decompression, the petrosal vein is often used as the barricade vein in the obstruction operation. Affects the operation of surgical field exposure and obstruction surgery. Therefore, the management of the petrosal vein is an important part of the operation, and it is also an important link to reduce the serious postoperative complications.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R651.3

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