三芯穿刺法在三叉神经节球囊压迫术中的应用研究*

Applied research of three core puncture method in Percutaneous Balloon Compression for Trigeminal Neuralgia

摘要:

目的：探讨三芯穿刺法球囊压迫术治疗原发性三叉神经痛的有效性和安全性。方法：选择2021年1月至2021年10月菏泽市立医院和广西医科大学第二附属医院就诊的原发性三叉神经痛病人80例，按随机数字表法随机分为单芯法组（D组）和三芯法组（S组），每组40例。两组均在Dyna-CT引导下行三叉神经节球囊压迫术。比较两组充盈“梨”形的穿刺次数、手术时间、球囊容量、球囊破裂次数和相关并发症（面部疱疹、麻木、复视、角膜炎）等指标，并比较术前和术后1天、1月、6月的疼痛数字评分法 (numerical rating scale, NRS) 评分和术后6月的有效率。结果：D组穿刺次数多于S组（P < 0.05），D组手术时间长于S组（P < 0.05），两组球囊容量、球囊破裂次数比较差异无统计学意义。两组术后各时间点NRS评分低于术前（P < 0.05），两组术后1月、6月NRS评分均小于术后1天（P < 0.05）。两组术后6月有效率差异无统计学意义。两组病人面部疱疹、麻木、复视、角膜炎发生率比较差异无统计学意义。结论：三芯穿刺法和单芯穿刺法疗效及安全性并无差异，但三芯穿刺法可明显减少穿刺次数和缩短手术时间，值得推荐。

Abstract:

Objective: To investigate the efficacy and safety of three core puncture in Percutaneous Balloon Compression（PBC） for primary trigeminal neuralgia（PTN）. Methods: Eighty patients with primary trigeminal neuralgia admitted to Heze Municipal Hospital and the Second Affiliated Hospital of Guangxi Medical University from January 2021 to October 2021 were randomly divided into single core puncture group (group D, 40 patients) and three needle core puncture group (group S, 40 patients). Both groups were treated with dyna-CT guided trigeminal ganglion balloon compression. The data of puncture frequency, operation time, balloon expanded volume and some complications of balloon rupture, facial herpes, numbness, diplopia and keratitis was collected and compared between the two groups. The NRS scores of patients at the time of preoperative ,posteoperative 1 day,1 month and 6 months and efficacy of 6 months’ follow-up were compared between the two groups. Results: The puncture frequency in group D was more than that in group S (P < 0.05), and the operation time in group D was longer than that in group S (P < 0.05). There was no statistical difference in balloon expanded volume and balloon rupture times between the two groups. The NRS scores of both groups at various time points postoperatively were lower than those before operation (P < 0.05), and the NRS scores at 1 month and 6 months postoperatively of both groups were lower than that at 1 day after operation (P < 0.05). There was no significant difference in efficacy between the two groups at six months after operation. There was no significant difference in the incidence of facial herpes, numbness, diplopia and keratitis between the two groups. Conclusion: There is no difference in efficacy and safety between three needle core puncture method and the single core puncture method, but the three core puncture method can significantly reduce the puncture frequency and shorten the operation time, which is worthy of recommendation.