1CT引导下半月神经节脉冲射频治疗重度原发三叉神经痛.docVIP

CT引导下半月神经节脉冲射频治疗重度原发三叉神经痛 罗芳 申颖 孟岚 刘延青 (首都医科大学附属北京天坛医院疼痛中心，北京100050) 摘自《中国疼痛医学杂志》2014,20 (5) 摘要 目的：报道CT引导下半月神经节脉冲射频治疗20例重度原发三叉神经痛患者的疗效。 方法： 脉冲射频治疗20例三叉神经痛患者，记录患者治疗前及治疗后1年内疼痛数字评分、辅助药物治疗、并发症及不良反应发生情况。结果：术后7例（35%）患者获得比较满意的疗效；13例（65%）患者疗效差、改行射频热凝术治疗后疼痛缓解但均出现面部麻木感和咀嚼肌力弱。脉冲射频治疗后患者无明显的不良反应及并发症。结论：CT引导下半月神经节脉冲射频治疗重度原发三叉神经痛虽然穿刺更准确、无不良反应发生、但是有效率较低，有待开展深入的实验与临床研究改进脉冲射频技术以提高治疗三叉神经痛的疗效。 关键词 三叉神经痛；治疗；射频；脉冲 CT GUIDED GASSERIAN GANGLION PULSED RADIOFREQUENCY TREATMENT FOR SERIOUS PRIMARY TRIGEMINAL NEURALGIA LUO Fang，SHEN Ying，MENG Lan，LIU Yan-Qing （Department of Pain，Beijing Tiantan Hospital, Capital Medical University, Beijing100050） AbstractObjective: To investigate the ef?cacy and safety of CT-guided Gasserian ganglion pulsed radiofre-quency treatment (PRFT) for serious primary trigeminal neuralgia (TN). Methods: 20 TN patients underwent CT-guided PRFT from Pain scores of Numeric rating scale were recorded preprocedure, and at different time points of postprocedure (1 day, 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year) ;Medication usage, complications and side effects were also recorded during the one year follow-up after procedure. Results: Approximately 35% (7/20) patients demonstrated a signi?cant improvement in pain scores after one year follow-up. 65% (13/20) patients had received another procedure of radiofrequency ablation because of no statistically difference after one year follow-up compared with preprocedure. Conclusions: This study demonstrated that CT-guided PRFT is not an effective method for idiopathic TN patients although the procedure of PFRT has few complications. Key wordsTrigeminal neuralgia; Treatment; Radiofrequency; Pulsed 脉冲射频在三叉神经痛的治疗中并未获得研究者的一致认同。2003年一项初步临床研究[1]认为脉冲射频对高龄及有并发症的原发性三叉神经痛患者疗效满意。然而，2007年一项前瞻性、随机、双盲研究[2]指出脉冲射频治疗原发性三叉神经痛时尽管没有明显的不良反应，但疗效远较传统的射频热凝技术差。 目前国外仅有的两项脉冲射频治疗原发三叉神经痛的临床研究均在X线透视辅助下完成。本研究采取三维CT精确定位引导穿刺过程、保证穿刺准确性，观察了半月神经节脉冲射频治疗原发三叉神经痛的疗效，进一步评价脉冲射频在治疗三叉神经痛患者方面的临床应用价值。 方法 1.一般资料 北京天坛医院疼痛科就诊的重度原发三叉神经痛患者20例进入本研究。入组标准：年龄18岁以上；头