C形臂结合皮区刺激电位引导穿刺行三叉神经半月节射频治疗

TRIGEMINAL SEMILUNAR GANGLION RADIOFREQUENCY ABLATION GUIDED BY X-RAY IMAGE COMBINED WITH DERMA ELECTROGRAPH

摘要:

目的:研究C形臂后前位 正侧位影象结合皮区刺激电位引导穿刺行半月神经节射频治疗的临床优缺点。方法:按入院顺序选择20例原发性三叉神经痛患者为研究对象,C形臂后前位 正侧位影象指导下前外侧入路穿刺卵圆孔,记录低频电刺激下三叉神经三个分支支配区的皮肤电位,依电位强弱决定穿刺针深度和方向再行射频热凝毁损。随机选择前期15例盲穿半月神经节射频毁损患者和15例单纯C形臂定位半月神经节射频毁损患者为对照,比较穿刺过程顺利程度和近、中期疗效。结果:C形臂结合皮区刺激电位引导穿刺行半月神经节射频治疗穿刺次数少,但总治疗操作时间延长,患者的近中期疗效显著优于其它对照组。结论:C形臂结合皮区刺激电位引导穿刺行半月神经节射频治疗显著提高了治疗质量。

Abstract:

Objective:To investigate the merits and demerits of percutaneous trigeminal ganglion radiofrequency ablation guided by X-ray image combined with derma electrograph.Methods:Twenty patients with primary trigeminal neuralgia selected according to the admitting time order to the hospital were involved in the study.In the treatment,the foramen ovale was punctured by anterior-external route and the procedure was guided by X-ray image in posterior-anterior direction and in side-to-side direction respectively.After the foramen ovale puncture was achieved,the derma electrograph induced by low-frequency electrical stimulation with radiofrequency needle was recorded synchronously in three trigeminal branches distributing area and the needle depth was then regulated following the induced potential.Other 15 patients treated previously whose foramen ovales puncturing were performed only according to the clinic sense and 15 patients in whom the puncture were guided only by X-ray image were randomized into two control groups.Results:The treatment in the study group showed less puncturing modulation and more time of total treating procedure and more excellent curative effects in short and medium terms comparing with the two control groups.Conclusion:Trigeminal ganglion radiofrequency ablation guided by X-ray image and derma electrograph seemed to be useful and economical.The treatment following the procedure could improve the therapeutic quality of trigeminal neuralgia.