摘要
目的探讨射波刀对原发性三叉神经痛的临床治疗效果。方法随机选取解放军第一一七医院2013年7月—2014年7月收治的80例原发性三叉神经痛患者作为研究对象,采用数字法随机分为2组,每组各40例,所有患者治疗前均进行CT或MRI检查,排除脑部肿瘤对治疗效果的影响。对照组采用伽马刀治疗,研究组采用射波刀治疗,靶点位置为三叉神经根入桥脑段前2.5 mm处,准直器标准为4 mm,剂量曲线区间为70%~90%,中心剂量为66.50~84.25 Gy,边缘剂量为60~66 Gy,靶点大小为4.0 mm×3.0 mm,4.0×(3.7~5.0)mm^2。治疗后随访12个月,对比分析2组患者的临床治疗效果及二次治疗发生率。结果研究组的治疗总有效率为90.0%,对照组治疗总有效率为87.5%,组间对比差异不具有统计学意义(P>0.05)。治疗后随访12个月,研究组2例靶点确定不精确,经CT脑池造影重新确定靶点,进行二次治疗,二次治疗率为5%,对照组4例进行二次治疗,二次治疗率为10.0%,研究组二次治疗率略低于对照组,但差异无统计学意义(P>0.05)。结论与伽马刀相比,射波刀对原发性三叉神经痛的临床治疗效果较为明显,适合于临床推广使用。
Objective To study the effect of treating primary trigeminal neuralgia with cyberknife. Methods Eightycases of primary trigeminal neuralgia patients were chosen from Jun. 2013 to Jun. 2014,to divide into study group and controlled group with 40 cases in each to detect CT or MRI before excluding brain tumor. The study group were treated with cyberknife,Target location for brain trigeminal nerve root into the bridge section of 2. 5 mm,standard for 4 mm collimator,dose curve range is 70%- 90%,center dose was 66. 50- 84. 25 Gy,edge dose was 60- 66 Gy,target size is 4. 0 × 3. 0mm squared,4. 0 ×（3. 7- 5. 0） mm. The controlled group was treated with gamma knife. The followed-up was 12 months to analyze effect and incidence of second treatment. Results The total effective rate of study group was 90%,higher than87. 5% of controlled group（ P〈0. 05）. There were 2 cases targets not accurate to treat with second treatment,the incidence of second treatment was 5%. The incidence of second treatment was 10. 0% of controlled group with 4 cases（ P〈0. 05）. Conclusion The Key point of treating with cyberknife and gamma knife is choosing targets and doses. And treating trigeminal neuralgia with cyberknife is effective to extend in clinic.
出处
《中华全科医学》
2016年第4期578-579,594,共3页
Chinese Journal of General Practice
关键词
射波刀
伽马刀
三叉神经痛
Cyberknife
Gamma knife
Primary trigeminal neuralgia
作者简介
通信作者：吴玉泉，E—mail：wyqxl@hotmail．com
