传统直针与改良弯针入路经圆孔治疗三叉神经第Ⅱ支痛的临床疗效分析

CLINICAL ANALYSIS OF TRADITIONAL STRAIGHT NEEDLE AND MODIFIED CURVED NEEDLE IN THR TREATMENT OF TRIGRMINAL NEURALGIA V2

摘要:

目的：回顾性比较在CT引导下传统直针与改良弯针入路经圆孔行射频热凝术治疗原发性三叉神经第Ⅱ支痛的疗效及安全性。方法：回顾性分析91例原发性三叉神经第Ⅱ支痛患者,根据治疗方式将患者分为T、G两组。将CT引导下直针经下颌骨髁突冠突间切迹入路穿刺圆孔进行治疗的定为T组,将CT引导下弯针经颧弓与下颌骨冠状突前缘交点入路穿刺圆孔治疗的定为G组。比较T、G两组患者术中穿刺次数、术中CT照射次数;两组患者术后满意度(Patient satis—faction survey,PSS)评分；术后各时间段的疼痛视觉模拟评分法 (visual analogue scale, VAS)。结果：T、G两组术后VAS评分较治疗前明显降低(P < 0.05),两组术后PSS评分无统计学差异(P＞0.05)。G组术中穿刺次数小于T组 (T组4.03±0.84次,G组3.84±0.71次,P＞0.05)；G组术中 CT定位照射次数小于T组(T组4.04±0.54次,G组3.73±0.54次,P < 0.05)。结论：传统直针与改良弯针入路均是有效的治疗方式,改良穿刺入路相较于传统穿刺入路来说穿刺次数更少,术中CT照射次数更少,更容易成功。

Abstract:

Objective：To retrospectively compare the efficacy and safety of traditional straight needle and modified curved needle approach in the treatment of primary trigeminal neuralgiaⅡ through round hole under CT guidance. Methods: 91 patients with primary trigeminal neuralgia were analyzed retrospectively. According to the existing treatment methods, the patients were divided into two groups.Group T was the traditional straight needle approach (CT guided straight needle puncture through the round hole through the upper approach of the intercondylar coronal notch of the mandible) and group G was the improved curved needle approach (CT guided curved needle puncture round hole through the intersection of zygomatic arch and anterior edge of mandibular coronal process). The puncture times and CT positioning irradiation times in the group of patients in T and G groups were compared; The PSS(Patient satis—faction survey) scores of the two groups were compared, and the VAS(Visual Analogue Sere，VAS) scores of the two groups before operation (T0), one day after operation (T1) ,14 days after operation (T2) and six months after operation (T2) were compared. Results: the pain of patients in T and G groups was significantly relieved after treatment. Compared with that before treatment, the VAS score after operation was significantly reduced (P < 0.05). There was no significant difference in PSS scores between the two groups (P > 0.05).The number of intraoperative puncture in group G was less than that in group t (4.03 ± 0.84 times in group T and 3.84 ± 0.71 times in group G, P > 0.05); The number of intraoperative CT positioning irradiation in group G was less than that in group t (4.04 ± 0.54 times in group T and 3.73 ± 0.54 times in group G, P < 0.05).Conclusion: The traditional straight needle and the improved curved needle approach are effective treatment methods. Compared with the traditional puncture approach, the improved puncture approach has less puncture times and less intraoperative CT irradiation times, which is easier to succeed