[1]汪洋,李亦梅.经皮穿刺微球囊压迫术与射频热凝术治疗原发性三叉神经痛疗效比较[J].新乡医学院学报,2022,39(10):959-963.[doi:10.7683/xxyxyxb.2022.10.011]
　WANG Yang,LI Yimei.Comparison of curative effect between percutaneous microballoon compression and radiofrequency thermocoagulation in the treatment of primary trigeminal neuralgia[J].Journal of Xinxiang Medical University,2022,39(10):959-963.[doi:10.7683/xxyxyxb.2022.10.011]
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经皮穿刺微球囊压迫术与射频热凝术治疗原发性三叉神经痛疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年10
页码:
959-963
栏目:
临床研究
出版日期:
2022-10-05

文章信息/Info

Title:
Comparison of curative effect between percutaneous microballoon compression and radiofrequency thermocoagulation in the treatment of primary trigeminal neuralgia
作者:
汪洋; 李亦梅
（新疆医科大学第一附属医院疼痛科，新疆　乌鲁木齐　830000）
Author(s):
WANG Yang; LI Yimei
(Department of Painology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang Uygur Autonomous Region,China)
关键词:
经皮穿刺球囊压迫术; 射频热凝术; 原发性三叉神经痛; 白细胞介素-1β; 白细胞介素-6; 肿瘤坏死因子-α
Keywords:
percutaneous microballoon compression; radiofrequency thermocoagulation; primary trigeminal neuralgia; interleukin-1β; interleukin-6; tumor necrosis factor-α
分类号:
R651.3
DOI:
10.7683/xxyxyxb.2022.10.011
文献标志码:
A
摘要:
目的　比较微球囊压迫术（PMC）与射频热凝术（RFT）治疗原发性三叉神经痛的临床效果。方法　选择2021年3月至10月新疆医科大学第一附属医院和郑州大学第一附属医院收治的80例原发性三叉神经痛患者为研究对象，依据治疗方法将患者分为RFT组和PMC组，每组40例。RFT组患者给予CT或C臂引导下三叉神经半月节射频热凝治疗，PMC组患者给予CT引导下经皮穿刺微球囊压迫三叉神经半月节治疗。分别于术前和术后第3天采用酶联免疫吸附试验法检测2组患者血清白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平；术前、术后第3天及1、3个月，应用数字评价量表（NRS）评估患者的疼痛程度，采用匹兹堡睡眠质量指数（PSQI）评估患者的睡眠质量；所有患者术后随访3个月，观察面部麻木、咬肌无力、口唇疱疹、听力减退及眼部不适等并发症及三叉神经痛复发情况。结果　2组患者术前血清IL-1β、IL-6、TNF-α水平比较差异无统计学意义（P>0.05），2组患者术后第3天血清IL-1β、IL-6、TNF-α水平显著低于术前（P<0.05）；术后第3天，PMC组患者血清IL-1β、IL-6、TNF-α水平显著低于RFT组（P<0.05）。2组患者术前疼痛NRS评分、睡眠质量PSQL评分比较差异无统计学意义（P>0.05），2组患者术后第3天及1、3个月时疼痛NRS评分、睡眠质量PSQL评分均显著低于术前（P<0.05）；术后第3天及1、3个月，PMC组患者疼痛NRS评分、睡眠质量PSQL评分均显著低于RFT组（P<0.05）。PMC组患者术后面部麻木、咬肌无力、口唇疱疹、听力减退及眼部不适的发生率分别为72.50%（29/40）、22.50%（9/40）、7.50%（3/40）、17.50%（7/40）、27.50%（11/40）；RFT组患者术后面部麻木、咬肌无力、口唇疱疹、听力减退及眼部不适的发生率分别为57.50%（23/40）、17.50%（7/40）、2.50%（1/40）、7.50%（3/40）、12.50%（5/40）；2组患者术后咬肌无力、口唇疱疹的发生率比较差异无统计学意义（χ2=2.176、2.736，P>0.05），PMC组患者面部麻木、听力减退及眼部不适的发生率均显著高于RFT组（χ2=5.783、3.516、6.719，P<0.05）。术后3个月内，RFT组和PMC组患者复发率分别为7.50%（3/40）、2.50%（1/40），2组患者复发率比较差异无统计学意义（χ2=0.263,P>0.05）。结论　PMC和RFT均是治疗原发性三叉神经痛的有效方法。与RFT比较，PMC可以更有效地抑制原发性三叉神经痛患者的炎症反应，减轻患者疼痛，改善患者睡眠质量，但术后患者面部麻木、听力减退及眼部不适的发生率较高。
Abstract:
Objective　To compare the clinical effect of percutaneous microballoon compression (PMC) and radiofrequency thermocoagulation (RFT) in the treatment of primary trigeminal neuralgia.Methods　A total of 80 patients with primary trigeminal neuralgia who admitted to the First Affiliated Hospital of Xinjiang Medical University and the First Affiliated Hospital of Zhengzhou University from March to October 2021 were selected as the research subjects,and the patients were divided into RFT group and PMC group according to the treatment methods,with 40 cases in each group.The patients in the RFT group were treated with radiofrequency thermocoagulation for gasserian ganglion under the guidance of CT or C-arm,and the patients in the PMC group were treated with CT-guided percutaneous microballoon compression of the trigeminal meniscus.The levels of serum interleukin-1β (IL-1β),interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay before operation and on the 3rd day after operation.At the time points of preoperation and the 3rd day and 1st,3rd month after operation,the pain degree of patients was evaluated with the numerical rating scale (NRS),and the sleep quality of patients was evaluated with the Pittsburgh sleep quality index (PSQI).All patients were followed up for three months to observe the complications such as facial numbness,masseter weakness,herpes labialis,hearing loss and eye discomfort,and the recurrence of trigeminal neuralgia was observed.Results　There was no significant difference in the levels of serum IL-1β,IL-6 and TNF-α of patients between the two groups before operation (P>0.05).The levels of serum IL-1β,IL-6 and TNF-α of patients on the 3rd day after operation were significantly lower than those before operation in the two groups (P<0.05).The levels of serum IL-1β,IL-6 and TNF-α in the PMC group were significantly lower than those in the RFT group on the 3rd day after operation (P<0.05).There was no significant difference in the NRS score of pain and the PSQL score of sleep quality between the two groups before surgery (P>0.05).The NRS score of pain and the PSQL score of sleep quality at the time points of the 3rd day and the 1st and 3rd month after operation were significantly lower than those before operation in the two groups (P<0.05).At the time points of the 3rd day and the 1st and 3rd month after operation,the NRS score of pain and the PSQL score of sleep quality in the PMC group were significantly lower than those in the RFT group (P<0.05).The incidences of postoperative facial numbness,masseter muscle weakness,herpes labialis,hearing loss and eye discomfort in the PMC group were 72.50%(29/40),22.50%(9/40),7.50%(3/40),17.50%(7/40) and 27.50%(11/40),respectively.The incidences of postoperative facial numbness,masseter muscle weakness,herpes labialis,hearing loss and eye discomfort in the RFT group were 57.50%(23/40),17.50%(7/40),2.50%(1/40),7.50%(3/40) and 12.50%(5/40),respectively.There was no significant difference in the incidence of masseter muscle weakness and herpes labialis between the two groups after surgery (χ2=2.176,2.736;P>0.05).The incidences of facial numbness,hearing loss and eye discomfort in the PMC group were significantly higher than those in the RFT group (χ2=5.783,3.516,6.719;P<0.05).Within three months after surgery,the recurrence rate of patients in the RFT group and PMC group was 7.50% (3/40) and 2.50% (1/40),respectively.There was no significant difference in the recurrence rate between the two groups(χ2=0.263,P>0.05).Conclusion　Both PMC and RFT are effective methods for the treatment of primary trigeminal neuralgia.Compared with the RFT,the PMC can more effectively inhibit the inflammatory response,relieve pain,and improve sleep quality of patients with primary trigeminal neuralgia,but it has high incidences of postoperative facial numbness,hearing loss and eye discomfort.

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更新日期/Last Update: 2022-10-05