本文已被：浏览 439次 下载 56次
投稿时间：2024-07-14 网络发布日期：2025-02-20
投稿时间：2024-07-14 网络发布日期：2025-02-20
中文摘要: 目的 探讨神经导航引导下行经皮球囊压迫术（PBC）对老年患者三叉神经痛的精确治疗的临床应用效果。方法 回顾性分析南京医科大学第一附属医院2021年5月至2022年9月收治的93例原发性三叉神经痛老年患者，以采用微血管减压术（MVD）治疗的45例为MVD组，选择患侧乙状窦后入路微创开颅行MVD；采用PBC治疗的48例为PBC组，患者术前行头颅MRI、头颅CT扫描重建卵圆孔及Meckel囊腔并在神经导航引导下行PBC对三叉神经痛进行精准治疗。随访12个月，比较两组患者手术时长、住院时长、临床疗效、复发率以及并发症发生率。结果 PBC组的手术时长及住院时长均显著短于MVD组［（21.21±5.09)min vs (118.40±15.79)min，(3.67±0.80)d vs (12.42±2.29)d，P＜0.01］。PBC组和MVD组总有效率（97.7% vs 93.3%，P＞0.05）、复发率（20.8% vs 13.3%，P＞0.05）差异无统计学意义，复发患者均再次行PBC治疗，疗效满意。两组均未发生死亡及其他严重并发症，PBC组面部麻木及口唇部疱疹并发症发生率高于MVD组（85.4% vs 8.9%，31.2% vs 11.1%，P＜0.05），两组所有并发症均在1年内恢复。结论 PBC和MVD手术有效率和复发率无差异，均可有效缓解疼痛，PBC以其微创性显著缩短了手术和住院时长。对于不适合开颅手术的高龄患者，神经导航引导下行PBC提供了一种安全、有效的三叉神经痛治疗方案。
Abstract:Objective To explore the clinical application effect of percutaneous balloon compression (PBC) under neuronavigation guidance for the precise treatment of trigeminal neuralgia in elderly patients. Methods A retrospective analysis was conducted on 93 elderly patients with primary trigeminal neuralgia admitted to the First Affiliated Hospital with Nanjing Medical University from May 2021 to September 2022. Forty-five patients treated with microvascular decompression surgery (MVD) were selected as the MVD group, with minimally invasive craniectomy performed with MVD by the posterior approach of the sigmoid sinus on the affected side. Forty-eight patients treated with PBC were selected as the PBC group. The patients underwent preoperative cranial MRI and cranial CT scanning to reconstruct the foramen ovale and Meckel's capsule cavity and underwent PBC under neuronavigation guidance for precise treatment of trigeminal neuralgia. The patients in the two groups were followed up for 12 months to compare the length of surgery, length of hospitalization, clinical efficacy, recurrence rate, and complication rate. Results The surgical duration and hospitalization duration in the PBC group were significantly lower than those in the MVD group ［(21.21±5.09)min vs (118.40±15.79)min, (3.67±0.80)d vs (12.42±2.29)d, P＜0.01］. There was no statistically significant difference in the overall effective rate (97.7% vs 93.3%, P＞0.05) and recurrence rate (20.8% vs 13.3%, P＞0.05) between the PBC group and MVD group. For recurrent patients, PBC treatment was performed again, and the effect was satisfactory. The incidence of facial numbness and lip herpes were higher in the PBC group than in the MVD group (85.4% vs 8.9%, 31.2% vs 11.1%, P＜0.05), and all complications in both groups were recovered within one year. Conclusions PBC and MVD surgeries have no difference in effectiveness and recurrence rates, both of which can effectively relieve pain. PBC significantly shortens the duration of surgery and hospitalization with its minimally invasive nature. For elderly patients who are not suitable for craniotomy surgery, PBC under neuronavigation guidance provides a safe and effective treatment for trigeminal neuralgia.
keywords: Neuronavigation Percutaneous balloon compression Microvascular decompression Primary Trigeminal neuralgiatrigeminal neuralgia Elderly
文章编号： 中图分类号：R745.1+1 文献标志码：A
基金项目:江苏省科教能力提升工程（ZDXK202225）
附件
| 作者 | 单位 |
| 曹纹平 | 1.南京医科大学第一附属医院神经外科，江苏 南京 210029 |
| 王宇航 | 1.南京医科大学第一附属医院神经外科，江苏 南京 210029 |
| 徐修鹏 | 1.南京医科大学第一附属医院神经外科，江苏 南京 210029 |
| 王彬彬 | 1.南京医科大学第一附属医院神经外科，江苏 南京 210029 |
| 徐文华 | 2.南京医科大学第一附属医院运营管理处，江苏 南京 210029 |
引用文本：
曹纹平,王宇航,徐修鹏,等.神经导航引导下经皮球囊压迫术治疗老年患者原发性三叉神经痛的效果[J].中国临床研究,2025,38(2):247-251.
曹纹平,王宇航,徐修鹏,等.神经导航引导下经皮球囊压迫术治疗老年患者原发性三叉神经痛的效果[J].中国临床研究,2025,38(2):247-251.