摘要
目的探讨锁孔微血管减压手术治疗颅神经疾病的疗效和安全性。方法本组男35例,女77例,年龄27~79岁,病程1~10年,其中三叉神经痛62例,面肌痉挛48例,三叉神经痛合并面肌痉挛1例,舌咽神经痛1例。所有患者术前行CT和MRI检查,排除颅内占位性病变后,在全麻下行锁孔微血管减压手术。结果 62例三叉神经痛患者中58例术后疼痛症状消失,手术有效率为93.55%,48例面肌痉挛患者中44例术后痉挛停止或显著减轻,手术有效率为91.67%,1例三叉神经痛合并面肌痉挛术后疼痛及痉挛均消失,1例舌咽神经痛术后疼痛症状消失。本组术后出现听力下降10例,口唇疱疹5例,迟发性面瘫2例,一过性头晕、耳鸣2例,脑脊液耳漏2例,蛛网膜下腔出血1例,幕上双侧硬膜下血肿1例,均经对症处理好转。随访发现5例患者症状复发,复发率为4.46%。结论锁孔微血管减压术是治疗颅神经疾病最有效的方法,熟练的显微外科技术、术中正确识别责任血管以及充分的减压是提高手术疗效、减少症状复发的关键。
Objective To explore the effect and safety of key-hole microvascular decompression for the treatment of cranial rhizopathies.Methods There were 35 males and 77 females.Their age ranged from 27 to 79 years,and their illness duration from 1 to 10 years.Among them there were 62 cases with trigeminal neuralgia,48 cases with hemifacial spasm,1 case with trigeminal neuralgia accompanied by hemifacial spasm,and 1 case with glossopharyngeal neuralgia.All the patients underwent CT and MRI examination before the operation.After removing the possibility of intracranial occupying lesion,key-hole microvascular decompression was performed under general anesthesia.Results The effective rate of trigeminal neuralgia was 93.55%(58/62) and hemifacial spasm 91.67%(44/48).The symptoms of the two cases with trigeminal neuralgia accompanied by hemifacial spasm and glossopharyngeal neuralgia disappeared after the operation.Hearing loss appeared in 10 cases,herpes labialis in 5 cases,delayed facial paralysis in 2 cases,transient dizziness and tinnitus in 2 cases,CSF otorrhea in 2 cases,SAH in 1 case and bilateral supratentorial subdural hematoma in 1 case.After active symptomatic treatments all the symptoms improved.The follow-up showed 5 cases(4.46%) recurred.Conclusion Key-hole microvascular decompression is the most effective way for the treatment of cranial rhizopathies.In order to improve the surgical effect and to reduce symptom recurrence,the key points are skilled microsurgical technique、correct identification of the responsible vessel and adequate decompression during the operation.
作者
王焕明
胡飞
陈俊
肖恺
熊玉波
杨崇阳
陈阳
尹都
Wang Huanming;Hu Fei;Chen Jun(Department of Neurosurgery,Wuhan Brain Hospital&Changhang General Hospital,Wuhan,430010)
出处
《立体定向和功能性神经外科杂志》
2019年第4期215-218,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
微血管减压术
颅神经疾病
疗效
Microvascular decompression
Cranial rhizopathies
Effect
