经皮球囊压迫术和射频热凝术治疗原发性三叉神经痛的有效性和安全性研究

Efficacy and safety of percutaneous balloon compression and radiofrequency thermocoagulation in the treatment of primary trigeminal neuralgia

摘要:

目的：比较经皮球囊压迫术和射频热凝术治疗原发性三叉神经痛(Primary trigeminal neuralgia,PTN)的疗效及安全性。方法：回顾性分析2020年11月至2022年3月在中日友好医院疼痛科收治的PTN患者110例,根据术式不同分为经皮球囊压迫组(P组,n=55)和射频热凝组(R组,n=53)。观察两组术前、术后1小时的视觉模拟评分 (visual analogue scale, VAS)、总体疗效、并发症发生情况,随访术后1个月、3个月、6个月、1年的两组疼痛复发率。结果：两组病人术前VAS评分无统计学差异,术后1小时VAS评分明显低于术前基础值(P < 0.01),两组术后1小时的VAS评分无统计学差异。两组总有效率无统计学差异。P组的整体面部麻木程度较R组轻(P＜0.05),两组术后出现口唇疱疹、角膜反射下降、干眼症、咀嚼肌无力的差异无统计学意义。两组患者术后1个月、3个月、6个月、12个月复发率比较无统计学差异。结论：经皮球囊压迫术和射频热凝术均可有效治疗PTN,均可出现面部麻木等并发症,1年后射频术组的复发率更高。

Abstract:

Objective: To compare the efficacy and safety of percutaneous balloon compression and radiofrequency thermocoagulation in the treatment of primary trigeminal neuralgia(PTN).Methods: A total of 110 patients with PTN admitted to the Pain Department of China-Japan Friendship Hospital from November 2020 to March 2022 were retrospectively analyzed and divided into percutaneous balloon compression(PBC) group (group P, n=55) and radiofrequency thermocoagulation(RFT) group (group R, n=53) according to different operation methods. Visual analogue scale (VAS), total efficacy and complications of the two groups were observed before and 1 hour after surgery. Pain recurrence rates of the two groups were followed up 1 month, 3 months, 6 months and 1 year after surgery.Results: There was no statistical difference in preoperative VAS score between the two groups, and the VAS score 1 hour after surgery was significantly lower than the preoperative basic value (P < 0.01), and there was no statistical difference in the VAS score 1 hour after surgery between the two groups. There was no significant difference in total effective rate between the two groups.The overall degree of facial numbness in group P was less severe than that in group R (P < 0.05), and there was no significant difference in herpes labialis, decreased corneal reflex, xerophthalmia and masticatory muscle asthenia between the two groups. There was no significant difference in recurrence rate at 1 month, 3 months, 6 months and 12 months between the two groups.Conclusion: Percutaneous balloon compression and radiofrequency thermocoagulation are both effective in the treatment of PTN, and both can cause complications such as facial numbness, and the recurrence rate is higher in the RFT after 1 year.