三叉神经痛微球囊压迫术后颅内感染2例

Two cases of intracranial infection after percutaneous microballoon compression of trigeminal neuralgia

摘要:

经皮穿刺三叉神经半月节微球囊压迫术（percutaneous balloon compression，PBC）是当今治疗三叉神经痛（trigeminal neuralgia，TN）的热门方式之一［1-2］。由于PBC的TN群体多以高龄为主，患者面部疼痛咀嚼困难导致营养不良，抵抗力差。畏惧面部清洁，油脂堆积，甚至伴有头颈部穿刺路径软组织间隙感染，PBC术后容易发生颅内感染，处理不当甚至危及生命［3-5］。目前关于TN患者PBC手术导致的颅内感染鲜有报道，笔者分析南京鼓楼医院神经外科2014年10月~2021年12月共行PBC手术治疗三叉神经痛1051例，2例发生颅内感染，经积极有效治疗均痊愈出院。结合相关文献探讨TN患者PBC手术颅内感染的危险因素，并总结预防及处理措施，为临床一线医师对该病症的诊治提供参考。

Abstract:

Percutaneous balloon compression (PBC) is one of the popular treatment methods for trigeminal neuralgia (TN) [1-2]. The patients with trigeminal neuralgia undergoing PBC surgery were mainly elderly, masticatory difficulty due to pain accompany with malnutrition, fear of facial cleaning because of pain accompany with oil accumulation, and even the possibility of infection in the skin and soft tissue space of the head and neck. Therefore, PBC puncture may lead to intracranial infection, improper treatment and even life-threatening [3-5].Postoperative intracranial infection is rarely reported. A total of 1051 patients with trigeminal neuralgia were treated by PBC surgery in our hospital from October 2014 to December 2021, and 2 cases occurred intracranial infection, which were cured and discharged after active and effective treatment. Combined with the experience of our center, we analyze the risk factors and management strategies for postoperative infection of trigeminal neuralgia PBC, in order to provide a reference for the diagnosis and treatment of this disease for neurosurgeons.