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目的探讨CT引导联合神经电生理测试射频热凝三叉神经半月节治疗原发性三叉神经痛的临床疗效。方法选取2013年5月至2014年1月中国医科大学附属第一医院疼痛科收治的156例原发性三叉神经痛患者,CT引导下按Hartel前入路法穿刺并结合神经电生理测试后行三叉神经半月节射频热凝术,损毁三叉神经相关感觉支,观察近期临床疗效并对中期疗效进行随访。结果 156例患者在CT引导下均可成功精确穿刺卵圆孔,结合电生理定位可精确做到选择性三叉神经半月节损毁。治疗后疼痛明显缓解,视觉模拟评分明显下降(P<0.05)。随访12个月有效率高达94.9%。6个月时复发5例,12个月时复发8例。结论 CT引导联合神经电生理试验能够精确定位卵圆孔及神经分支,射频热凝术能够安全、有效地治疗原发性三叉神经痛。
Objective To investigate the clinical efficacy of CT guided neuroendromycin in the treatment of primary trigeminal neuralgia with radiofrequency thermocoagulation. Methods From May 2013 to January 2014, 156 patients with primary trigeminal neuralgia admitted to the Department of Pain, the First Affiliated Hospital of China Medical University were enrolled in this study. They were treated by CT-guided Hartel anterior approach and combined with electrophysiological test Trigeminal nerve semilunar radiofrequency thermocoagulation, damaged trigeminal nerve related sensory branch, observed the recent clinical efficacy and follow-up of the medium-term efficacy. Results 156 cases of patients under the guidance of CT can be successfully punctured foramen ovale, combined with electrophysiological localization can be accurately done selective trigeminal nerve meniscal destruction. Pain was relieved after treatment, visual analogue scale was significantly decreased (P <0.05). Follow-up 12 months, the efficiency of up to 94.9%. 5 cases relapsed at 6 months and 8 cases relapsed at 12 months. Conclusion CT guided combined with neuroelectrophysiological test can accurately locate the foramen ovale and nerve branches. Radiofrequency thermocoagulation can safely and effectively treat primary trigeminal neuralgia.