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...