海南医科大学学报

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。

Objective:To summarize clinical experience of microvascular decompression(MVD) for idiopathic trigeminal neuralgia patients.Methods:Microvascular decompression was performed in 57 cases with idiopathic trigeminal neuralgia from Jun.2000 to Sept.2010.Clinical presentations,operative findings,operative technique and clinical outcome were analysed retrospectively.Results:Definite offending vessels were found to oppress the root exit zone of trigeminal nerve in all the patients.The offending vessels were identified and separated under microscrope through retrosigmoid approach.All of the patients were followed up for 6 months to 5 years after operation.The symptoms disappeared in 41 cases(72.0%),ameliorated obviously in 16 cases(28.0%);Transient ipsilateral facial numbness was found in 6 cases(10.5%),dry eye was found in 3 cases(5.2%).No persistent complication was found in all patients with total relief during the follow up period.Conclusions:Microvascular decompression is an effective and reliable treatment method for idiopathic trigeminal neuralgia.Achieving a complete decompression of the trigeminal nerve through finding,separating and releasing the offending vessels near the brain stem,is the key to a successful operation.