经皮穿刺麦克氏囊注射甘油治疗-第三军医大学学报.DOC

麦克氏囊甘油注射治疗三叉神经痛的临床疗效分析 陈立朝 邹咏文 许民辉 徐伦山 ( 第三军医大学第三附属医院神经外科，重庆400042) 摘要 目的 分析经皮穿刺麦克氏囊注射甘油治疗原发性三叉神经痛的疗效及其相关因素。方法 回顾性分析我科1983年12月～2010年6月采用经皮穿刺麦克氏囊注射甘油治疗三叉神经痛4873例。对症状、药物是否有效、穿刺成功的测试方法及穿刺时有无脑脊液流出等因素与疗效的关系进行分析。结果 近期治愈率为97.3％，3851例(79％)获随访1～26年，复发653例（16.96％），远期治愈率为83.04％，无严重并发症发生。分析表明，症状、术前口服药物是否有效、穿刺成功的测试方法及穿刺时有无脑脊液流出等因素均与疗效相关。结论 经皮穿刺麦克氏囊注射甘油治疗原发性三叉神经痛安全、微创、有效。症状典型、术前口服药物有效、穿刺成功的测试方法有效及穿刺时有脑脊液流出的患者，其疗效好。 关键词 三叉神经痛；甘油；麦克氏囊；疗效 Clinical analysis of treatment of trigeminal neuralgia with percutaneous glycerol injection into HYPERLINK /wiki/Meckel%27s_cave \o Meckels cave Meckels cavity Chen LiZhao, Zou YongWen, Xu MinHui, Xu LunShan Department of NeuroSurgery, Third Affiliated Hospital, Third Military Medical University,Chongqing, 400042, China 【Abstract】　Objectives To analyze the curative effect and related factors of treatment of trigeminal neuralgia with percutaneous glycerol injection into HYPERLINK /wiki/Meckel%27s_cave \o Meckels cave Meckels cavity. Methods Retrospective analysis of 4873 patients with trigeminal neuralgia treated with percutaneous glycerol injection into HYPERLINK /wiki/Meckel%27s_cave \o Meckels cave Meckels cavityour in our department from December 1983 to June 2010. To analyze the relationship between curative effect and varies of factors, such as symptoms, effectiveness of drugs, test method of successful puncture and whether the cerebrospinal fluid outflow, etc. Results The immediate success rate of the procedure was 97.3%. Follow-up was done in 3157 patients within1 – 26 years. The long-term success rate was 83.04%. Recurrence rate was 16.96%. No serious adverse effects were observed. The analysis showed that there was a significant connection between the curative effect and factors such as symptoms, the effectiveness of drugs, test method of successful puncture ,whether the cerebrospinal fluid outflow, etc. Conclusion The treatment of trigeminal neuralgia with percutaneous glycerol injection into HYPERLINK /wiki/Meckel%27s_cave