经圆孔及卵圆孔射频联合表柔比星治疗复发性三叉神经痛的临床研究

EFFECT ON CT-GUIDED PERCUTANEOUS RADIOFREQUENCY THROUGH FORAMEN ROTUNDUM AND FORAMEN OVALE COMBINED WITH EPIRUBICIN IN THE TREATMENT OF RECURRENT TRIGEMINAL NEURALGIA

摘要:

目的：探讨经圆孔及卵圆孔射频联合表柔比星治疗复发性三叉神经痛的疗效。方法：选择11例复发性三叉神经痛(Ⅱ+Ⅲ支)患者,在CT引导下经圆孔行上颌神经射频热凝,卵圆孔行下颌神经脉冲射频,同时分别注射0.66%表柔比星0.5ml。记录患者术前,术后1天、7天、6月的疼痛数字评分(numeric rating scales,NRS)和睡眠时间,采用巴罗神经学研究所(Barrrow Neurollogical Institute ,BNI)分级评定标准评估患者疼痛缓解程度及复发情况,记录患者术后并发症：面部感觉减退、咀嚼力下降、角膜炎等。结果：患者术后各时间点NRS评分较术前明显减少(P<0.05),睡眠时间较术前明显增加(P<0.05),术后1天、7天、6月的疼痛完全缓解率分别为81.8%,90.9%,81.8%,随访6月,未见复发。10例患者出现面部感觉减退,未出现咀嚼力下降和角膜炎等并发症。结论：经圆孔及卵圆孔射频联合表柔比星治疗复发性三叉神经痛的疗效确切,并发症少,安全性高,值得临床推广应用。

Abstract:

Objective：To study the curative effects of CT-guided radiofrequency through foramen rotundum and foramen ovale combined with epirubicin for recurrent trigeminal neuralgia.Methods:11 patients of recurrent trigeminal neuralgia (Ⅱ + Ⅲ) were selected to be treated with Radiofrequency thermocoagulation of maxillary nerve through the foramen rotundum under CT guided and Pulse radiofrequency of mandibular nerve through the foramen ovale ,and Epirubicin was injected at the same time respectively. Numeric rating scales(NRS) andSsleep time of the patients were recordedSbefore and 1 day, 7 days and 6 months after surgery .The pain relief and recurrence of the patients were assessed by classification of Barrrow Neurollogical Institute(BNI), and the postoperative complications including facial hypoesthesia, decreased chewing power, keratitis, dizziness and nausea were recorded.S Results :The postoperative NRS at each time point significantly decreased than which we obseved before surgery (P<0.05), and the sleep time was increased (P<0.05). The rate of complete pain relief at 1 day, 7 days and 6 months after surgery was 81.8%,90.9% and 81.8% respectively.no patient relapsed during the 6 months follow-up.10 patients presented with facial hypoesthesia,no decreased mastication, keratitis and other complications.Conclusion:CT-guided radiofrequency through foramen rotundum and foramen ovale combined with epirubicin hasScurative effect, less complication, high safety, less contraindications,and it provides a new minimally invasive treatment for recurrent trigeminal neuralgia(Ⅱ + Ⅲ).