微球囊压迫治疗三叉神经痛：不损伤同轴突的最佳压迫时间.docVIP

微球囊压迫治疗三叉神经痛：不损伤轴突的最佳压迫时间 经皮穿刺微球囊压迫术是治疗顽固性三叉神经痛较为可靠的新方法，但其止痛机制尚未完全明了，操作的各种参数如压迫时间、压力、球囊形状等目前仍无统一标准。尤其是球囊压迫时间与术后感觉方面并发症和术后疼痛复发问题，国际上一直处于争论之中。目前的压迫时间为五六分钟或更长一点，压迫时间长，可造成正常的神经轴突及髓鞘同时受损，导致患者术后面部麻木及感觉障碍，且恢复时间长；减少压迫时间，存在手术疼痛缓解率低及中、远期复发率高的风险。那么，怎样才能找到适合的压迫时间，使治疗成功率高又复发率低并能降低并发症的发生？中国医科大学附属盛京医院的李付勇博士所在课题组以家兔为实验对象，建立经皮穿刺球囊压迫三叉神经节的动物模型，发现压迫2，5 min均可导致三叉神经大的有髓纤维的脱髓鞘改变而不损伤轴突，但压迫5 min者损伤更重。作者认为，压迫时间缩短为2 min时同样能产生有髓神经纤维脱髓鞘的改变，使得疼痛传导受到抑制，从而产生止痛的效应，而延长时间至5 min的压迫导致髓鞘退变更严重，适合三叉神经痛复发患者的治疗。相关文章发表于《中国神经再生研究（英文版）》杂志2014年1月第2期。 透射电镜(×3000)见经皮穿刺球囊压迫兔三叉神经节2 min后的第7天兔三叉神经根大的有髓神经纤维的脱髓鞘改变 Article: Optimal duration of percutaneous microballoon compression for treatment of trigeminal nerve injury by Fuyong Li1, Shuai Han2, Yi Ma3, Fuxin Yi4, Xinmin Xu3, Yunhui Liu1 (1 Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang, Liaoning Province, China; 2 Department of Neurosurgery, the First Hospital of China Medical University, Shenyang, Liaoning Province, China; 3 Second Department of Neurosurgery, the People’s Hospital of Liaoning Province, Shenyang, Liaoning Province, China; 4 First Department of Neurosurgery, the First Affiliated Hospital, Liaoning Medical College, Jinzhou, Liaoning Province, China) Li FY, Han S, Ma Y, Yi FX, Xu XM, Liu YH. Optimal duration of percutaneous microballoon compression for treatment of trigeminal nerve injury. Neural Regen Res. 2014;9(2):179-189. 欲获更多资讯：请与《中国神经再生研究（英文版）》杂志国际发展部联络；联络电话：+8613804998773，或用电子邮件联络：eic@。 文章全文请见：/CN/article/openArticlePDF.jsp?id=849 Optimal duration of percutaneous microballoon compression for trigeminal nerve injury Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there are no standardized criteria, such as compression pressure, compression time or balloon shape, for the procedure. In particular, the links between compression duration and postoperativ