伽玛刀对神经根及毗邻血管不同解剖关系原发性三叉神经痛治疗疗效分析.docVIP

伽玛刀对神经根及毗邻血管不同解剖关系原发性三叉神经痛治疗疗效分析【摘要】目的探讨原发性三叉神经痛患者三叉神经根与毗邻血管的不同解剖关系对伽玛刀治疗疗效的影响。方法回顾性分析2004年1月至2009年1月山西医科大学第二医院伽玛刀中心治疗原发性痛患者82例,依据MR定位影像显示三叉神经根与毗邻血管的不同解剖关系(无接触、可疑接触、明确接触、推移),评估对伽玛刀治疗疗效的影响。结果随访6~18个月,平均随访12.5个月,依据BNI疼痛量表评分Ⅲ级以上70例,总有效率85.4%,三叉神经根与血管无接触组有效率89.7%,可疑接触组有效率86.4%,明确接触78.9%,推移组81.8%,复发8例(9.7%)。结论三叉神经根与毗邻血管的不同解剖关系对伽玛刀治疗疗效差别无统计学意义,推移组复发率较其他组高,远期疗效有待进一步评估。? 【关键词】原发性三叉神经痛 ;伽玛刀治疗;三叉神经根与毗邻血管解剖关系;疗效 ?? Assess the effects of different relationships between the root of trigeminal nerve and surrounding vasculars on gamma knife radiosurgery for trigeminal neuralgia XIE Fu-tang,XU Jian-xin.Gamma knife center2rd hospital Shanxi medical university,Taiyuan 030001,China ? 【Abstract】ObjectiveTo assess the different trigeminal nerve-blood vessel relationships and its effect on pain relief after gamma knife radiosurgery for trigeminal neuralgia.MethodsReview 82 patients treated during January 2004 and January2009,basing on MRI,analyzing trigeminal nerve-blood vessel anatomica relationships and its effects on pain relief.ResultsAll patients had been followed up from 6 to 18 months,median follow-up was 12.5 months.,according to Barrow Neurological Institute(BNI)pain scale,success results were achieved in 85.4% patients(no touch89.7%,suspicious touch 86.4%,certained touch78.9%,pushing81.8%),recurrence 9.7%.ConclusionThe different trigeminal nerve-blood vessel relationships have no stastical significant on pain relief.Recurrence rate in pushing is higher than the other categories.Gamma knife radiosurgery treatment for classic trigeminal neuralgia is safe and effective,the father effects need faraway research.? 【Key words】 Primary trigeminal neuralgia; Gamma knife Treatment;Effects 原发性三叉神经痛(classic trigeminal neuralgia,CTN)是一种以颜面部发作性剧烈疼痛为特点的神经科常见疾病。本文重点探讨三叉神经根与毗邻血管的不同解剖关系对伽玛刀治疗疗效的影响。? 1资料与方法? 1.1一般资料2004年1月至2009年1月山西医科大学第二医院OUR旋转式伽玛刀治疗原发性三叉神经痛患者82例,男35例,女47例,年龄40~75岁,平均63.5岁;左侧疼痛35例,右侧疼痛47例,其中第Ⅱ支42例,第Ⅲ支23例,Ⅱ+Ⅲ支12例,+Ⅱ+Ⅲ支5例,病程1~8年;其中0.05);多组二分类变量的卡方检