显微血管减压术治疗三叉神经痛和面肌痉挛的技术差别(附37例报告)

Technical difference in treating trigeminal neuralgia and hemifacial spasm by microvascular decompression: a respective analysis of 37 cases

摘要:

目的 为了提高手术安全性和疗效,减少术后并发症,探讨显微血管减压术治疗三叉神经痛和面肌痉挛的方法和技术细节差别.方法 回顾性分析37例显微血管减压术手术患者,其中三叉神经痛15例,面肌痉挛22例,分析术中体位,切口,骨窗,责任血管压迫等细节,观察二者术后疗效.结果 三叉神经痛患者术后疼痛立即完全缓解14例,1例延迟缓解.所有面肌痉挛患者痉挛症状术后即刻消失,无严重并发症.随访半年~2年,1例三叉神经痛患者复发,所有面肌痉挛患者未见复发.结论 显微血管减压术是治疗三叉神经痛和面肌痉挛的有效治疗方法,但在术中体位、切口、骨窗、责任血管压迫等具体操作细节方面有细微差别,了解这些差别有助于增加手术安全性,取得更好的疗效.

Abstract:

Objective To investigate the technical difference in treating trigeminal neuralgia (TN) and hemifacial spasm (HFS) by microvascular decompression (MVD) and to improve the safety and effect of MVD and reduce postoperative complications.Methods The clinical data of 37 patients (15 cases of TN and 22 cases of HFS) who received (or receiving) MVD were retrospectively analyzed. The details of patients such as body posture during operation, incision, bone window, and responsible blood vessel compression were analyzed, and the effects of MVD operation were assessed. Results Among the 15 TN patients, 14 cases achieved a complete remission immediately after operation and 1 case had delayed remission. Spasm symptom of all the HFS patients disappeared immediately after operation, and no case had severe complications. After a follow-up period of 0.5-2 years, 1 TN case had recurrence, while no HFS case had recurrence.Conclusions MVD is an effective treatment for TN and HFS, but there are small differences in details about intraoperative body posture, incision, bone window, and responsible blood vessel compression. Awareness of these differences helps to improve the safety and effect of operation.