显微血管减压术治疗原发性三叉神经痛的临床体会VIP免费

海南医学院学报2o10，16(12)1628Journc~lofHainanMedicalUniversityDOI：CNKI：46-1049／R．20101217．1104．007网络出版地址：http：／www．cnki．net／kcms／detail／46一lO49／R．20101217．1104．007．html显微血管减压术治疗原发性三叉神经痛的临床体会杨垄，蔡雄，王子珍，何理盛，黄秋虎，戴琳孙，马春阳，郑传宜，孙邦勇，陈政刚(1．海南医学院附属医院神经外科，海南海口570102；2．福建医科大学附属第一医院神经外科，福建福州350005)[摘要]目的：总结显微血管减压术治疗三叉神经痛的临床经验。方法：回顾性分析2000年6月~2010年9月间采用显微血管减压术治疗的57例三叉神经痛患者的临床表现、术中所见、手术技巧和临床疗效。结果：全部患者临床表现与其术中所见三叉神经受血管压迫有密切关系。57例患者术后随访6个月～5年，41例(72．0％)术后疼痛完全消失，16例(28．0)术后疼痛明显减轻；6例(10．5)术后同侧面部有一过性轻度麻木，3例(5．2)有轻度眼部干涩表现，所有患者无永久性并发症发生。结论：显微血管减压术治疗原发性三叉神经痛效果显著，手术时在三叉神经近脑干区发现责任血管并进行充分分离、松解，实现三叉神经彻底减压是手术成功的关键。[关键词]三叉神经痛；微血管减压术；显微外科[中图分类号]R651．3[文献标识码]B[文章编号]1007—1237(2010)12—1628—03OlinicalexperienceofmicrovasculardecompressionforidiopathictrigeminalneuralgiaYANGKun，CAIXiong，WANGZi—zhen，HEIi—sheng，HUANGQiu—hu，DAIIing—sun，MAChun—yang，ZHENGChuan—yi，SUNBang—yong，CHENZheng—gang(1．DepartmentofNeurosurgery，theAffiliatedHospitalofHainanMedicalUniversity，Haikou570102，China；2．DepartmentofNeurosurgery，theFirstAffiliatedHospitalofFujianMedicalUniversity，Fuzhou350005，China)[FoundationProject]：Hainan]ViedicalUnizersityScientificResearchFundSupportedProjectoftheJourna／(0020100441)[Author]：NGKun(1963一)，M．D．，Male，AnluHubei，Chie，’Physician，MasterTutor，z：0898—66528163，Ernail：chbyk@yahoo．foe．cn．Received：2010—12—02Revised：201O一12—15．，HMC，2O10；16(12)：1628—1630Viewfromspecialist：ItiScreative，andofcertainscientificandeducationalvalue．[ABSTRACT]Objective：Tosummarizeclinicalexperienceofmicrovasculardecompression(MVD)foridiopathictrigeminalneuralgiapatients．Methods：Microvasculardecompressionwasperformedin57caseswithidiopathictrigeminalneuralgiafromJun．2000toSept．2010．Clinicalpresentations，operativefindings，operativetechniqueandclinicaloutcomewereanalysedretrospectively．Results：Definiteoffen—dingvesselswerefoundtOoppresstherootexitzoneoftrigemlnalnerveinallthepatients．Theoffendingvesselswereidentifiedandseparatedundermicroscropethroughretrosigmoidapproach．Allofthepatientswerefollowedupfor6monthstO5yearsafteroperation．Thesymptomsdisappearedin41cases(72．0)，amelioratedobviouslyin16cases(28．0)；Transientipsilateralfacialnumbnesswasfoundin6cases(10．5)，dryeyewasfoundin3cases(5．2％)．Nopersistentcomplicationwasfoundinallpatientswith[收稿日期]2010-】2一O2[修回日期]2010l2l5网络出版时问：201012l7】1：O4[基金项目]海南医学院科研基金资助学报项目(0020100441)[作者简介]杨垄(1963)，男，湖北安陆人，主任医师，硕士研究生导师，博士，Tel：089866528163，Email：chbyk@yahoo．corn．cn。杨堑等．显微血管减压术治疗原发性三又神经痛的临床体会1629totalreliefduringthefollowupperiod．Conclusions：Microvasculardecompressionisaneffectiveandrelia—bletreatmentmethodforidiopathictrigeminalneuralgia．Achievingacompletedecompressionofthetri—geminalnervethroughfinding，separatingandreleasingtheoffendingvesselsnearthebrainstem，isthekeytOasuccessfuloperation...