微血管减压术治疗三叉神经痛患者的临床效果分析

目的:探究微血管减压术(Microvascular decompression,MVD)治疗三叉神经痛(Trigeminal neuralgia,TN)患者的临床效果。方法:回顾性分析2014年1月至2015年1月于我科经MVD治疗的TN患者,分析其预后及影响预后的相关因素。结果:120例TN患者中,单纯静脉压迫所致TN患者13例,单纯动脉压迫所致TN患者60例,混合性血管压迫所致TN患者46例。单纯静脉压迫患者术后1天、3月、1年、3年的缓解率分别为84.6%、76.9%、69.2%、61.5%。单纯动脉压迫患者为88.3%、85.0%、83.3%、70.0%。混合型压迫患者为93.5%、93.5%、91.3%、87.0%。A组患者术后1年、3年缓解率低于C组患者(P<0.05)。A组与B组、B组与C组术后1天、3月、1年缓解率比较均无统计学差异(P>0.05),但是C组术后3年缓解率显著高于B组(P<0.05)。结论:单纯静脉压迫TN患者MVD术后缓解率较单纯动脉压迫TN患者及混合性压迫TN患者低,混合性压迫TN患者长期缓解率最高。

A Study on the Effect of MVD on the Patients with Trigeminal Neuralgia

ABSTRACT Objective: To explore the clinical effect of Microvascular decompression (MVD) in the treatment of patients with Trigeminal neuralgia (TN). Methods: A retrospective analysis of patients with TN treated with MVD in our department from January 2014 to January 2015 was conducted, to investigate the prognosis and prognostic factors. Results: 120 cases of patients with TN were selected, including 13 patients with simple venous compression, 60 patients with simple arterial compression, and 46 patients with mixed compression. The remission rates of patients with simple venous compression at 1 day, 3 months, 1 year, and 3 years after surgery were 84.6%, 76.9%, 69.2% and 61.5%, and those with simple arterial compression were 88.3%, 85.0%, 83.3% and 70.0%, the patients with mixed compression were 93.5%, 93.5%, 91.3% and 87.0%, respectively. The remission rate of patients in group A was lower than that in group C at 1 year and 3 years after MVD(P<0.05). There was no significant difference in the remission rate between group A and group B, group B and group C at 1 day, 3 months and 1 year after surgery(P>0.05), but the remission rate in group C was significantly higher than that in group B after 3 years(P<0.05). Conclusion: The remission rate of MVD in TN patients with simple venous compression is lower than that in patients with arterial compression and mixed compression, patients with mixed compression have the highest long-term remission rate.