您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (4): 83-86.doi: 10.6040/j.issn.1671-7554.0.2014.764

• 临床医学 • 上一篇    下一篇

单纯神经内镜下微血管减压术治疗原发性三叉神经痛

王济潍, 李超, 陈腾, 张文华, 李卫国, 马翔宇, 徐淑军, 李新钢   

  1. 山东大学齐鲁医院神经外科 山东大学脑科学研究所, 山东 济南 250012
  • 收稿日期:2014-10-29 修回日期:2014-12-23 出版日期:2015-04-10 发布日期:2015-04-10
  • 通讯作者: 李新钢.E-mail:lixg@sdu.edu.cn;徐淑军.E-mail:xu-shujunql@163.com E-mail:lixg@sdu.edu.cn;xu-shujunql@163.com
  • 基金资助:
    山东省优秀中青年科学家科研奖励基金(BS2011YY019)

Simple endoscopic vascular decompression in the treatment of trigeminal neuralgia

WANG Jiwei, LI Chao, CHEN Teng, ZHANG Wenhua, LI Weiguo, MA Xiangyu, XU Shujun, LI Xingang   

  1. Department of Neurosurgery, Qilu Hospital of Shandong University; Brain Science Research Institute, Shandong University, Jinan 250012, Shandong, China
  • Received:2014-10-29 Revised:2014-12-23 Online:2015-04-10 Published:2015-04-10

摘要: 目的 探讨单纯内镜下微血管减压术治疗原发性三叉神经痛的方法及临床价值.方法 回顾性分析采用单纯神经内镜下微血管减压术治疗35例原发性三叉神经痛的临床资料,并对其疼痛缓解程度、手术时间和术后并发症发生率进行评估分析.结果 术中35例均在内镜下发现责任血管,平均手术时间为85.6 min;术后疼痛完全消失33例,疼痛较术前明显缓解2例,并发症发生率为2.8%;随访期间,无死亡及复发病例.结论 神经内镜能够单独完成三叉神经微血管减压术,可消除传统显微镜下手术的视野盲区,不易损伤血管、神经,明显减小对正常脑组织牵拉和损伤.故单纯内镜下微血管减压术可作为传统微血管减压术或神经内镜辅助微血管减压术的替代手术,有临床推广价值.

关键词: 神经内镜, 焦虑, 微血管减压术, 心理护理, 三叉神经痛, 复合疾病

Abstract: Objective To explore the operative technique and clinical value of simple endoscopic vascular decompression (EVD) for trigeminal neuralgia. Methods Clinical data of 35 cases of primary trigeminal neuralgia treated with simple EVD during Nov. 2013 and Sept. 2014 were retrospectively reviewed. Pain relief, operation time and postoperative complications were analyzed. Results Of all patients, 33 achieved immediate postoperative pain control and 2 obtained obvious pain relief. Mean operation time was 85.6 minutes and the complication rate was 2.8%. No death or recurrence were detected during follow-up. Conclusion Neuroendoscopy can complete trigeminal microvascular decompression alone, eliminate the blind area in traditional microscopic surgery, and significantly reduce the injury to blood vessels, nerves and brain tissues. Endoscopic vascular decompression is a safe and effective alternative for traditional microvascular decompression or neuroendoscopy-assisted microvascular decompression.

Key words: Trigeminal neuralgia, Microvascular decompression, Neuroendoscopy

中图分类号: 

  • R651.1
[1] Cohen-Gadol AA. Microvascular decompression surgery for trigeminal neuralgia and hemifacial spasm: Naunces of the technique based on experiences with 100 patients and review of the literature[J]. Clin Neurol Neurosurg, 2011, 113(10): 844-853.
[2] Teo C, Nakaji P, Mobbs RJ. Endoscope-assisted microvascular decompression for trigeminal neuralgia: technical case report[J]. Neurosurgery, 2006, 59(4): 489-490.
[3] Sarsam Z, Garcia-Finana M, Nurmikko TJ, et al. The long-term outcome of microvascular decompression for trigeminalneuralgia[J]. Br J Neurosurg, 2010, 24(1): 18-25.
[4] 常庆勇, 段云平, 高宝山, 等. 显微血管减压术治疗三叉神经痛的解剖学发现[J]. 中华神经外科杂志, 2007, 23(10): 746-748.
[5] 黄琦丹, 郑捷敏, 文超勇, 等. 显微血管减压术治疗35例原发性三叉神经痛患者疗效分析[J]. 中华脑科疾病与康复杂志, 2011, 1(2): 169-171. HUANG Qidan, ZHENG Jiemin, WEN Chaoyong, et al. Microvascular decompression treatment for 35 cases with primary trigeminal neuralgia[J]. Chin J Brain Dis Rehabil, 2011, 1(2): 169-171.
[6] Magnan J, Chays A, Lepetre C, et al. Surgical perspectives of endoscopy of the cerebellopontine angle[J]. Am J Otology, 1994, 15(3): 366-370.
[7] Miyazaki H, Deveze A, Magnan J. Neuro-otologic surgery through minimally invasive retrosigmoid approach: endoscope assisted microvascular decompression, vestibular neurotomy and tumor removal[J]. Laryngoscope, 2005, 115(9):1612-1617.
[8] Jarrahy R, Eby JB, Cha ST, et al. Fully endoscopic vascular decompression of the trigeminal nerve[J]. Minim Invasive Neurosurg, 2002, 45(1): 32-35.
[9] Setty P, Volkov AA, D'Andrea KP, et al. Endoscopic vascular decompress-ion for the treatment of trigeminal neuralgia: clinical outcomes and technical note[J]. World Neurosurg, 2014, 81(3-4):603-608.
[10] Kabil MS, Eby JB, Shahinian HK. Endoscopic vascular decompression versus microvascular decompression of the trigeminal nerve[J]. Minim Invasive Neurosurg, 2005, 48(4): 207-212.
[1] 张斌,张良文,迟令懿,王传伟,朱树干. 显微血管减压术治疗原发性三叉神经痛疗效的相关因素[J]. 山东大学学报(医学版), 2016, 54(6): 69-72.
[2] 冯子超,王济潍,李超,李卫国,陈腾,马翔宇,徐淑军,李新钢. 单纯神经内镜在桥小脑角区的手术应用[J]. 山东大学学报(医学版), 2016, 54(10): 71-75.
[3] 王春来, 徐淑军, 王洪亮, 尚景瑞. 神经内镜下外伤性脑脊液鼻漏修补的临床研究[J]. 山东大学学报(医学版), 2015, 53(3): 69-72.
[4] 余慧慧, 雷震, 王淑康, 潘芳. 老年高血压与糖尿病共病患者的不良情绪与相关因素[J]. 山东大学学报(医学版), 2015, 53(12): 81-85,96.
[5] 徐然, 马翔宇, 李卫国, 李超, 张鑫, 徐淑军, 李新钢. 神经内镜下乙状窦后锁孔入路微血管减压术治疗面肌痉挛[J]. 山东大学学报(医学版), 2015, 53(10): 55-57.
[6] 倪忆媚, 叶丽. 舒适护理在妇产科恶性肿瘤患者中的应用效果[J]. 山东大学学报(医学版), 2014, 52(Z2): 154-155.
[7] 刘卫华, 张小东, 商士渲. 1例维和任务区外籍患者心理护理[J]. 山东大学学报(医学版), 2014, 52(Z1): 171-172.
[8] 陈普艳. 围手术期亲情护理在手术室护理管理中的应用[J]. 山东大学学报(医学版), 2014, 52(Z1): 178-179.
[9] 黄娟萍, 康年松. 健康教育护理干预对功能性消化不良患者抗焦虑治疗依从性及随访率的影响[J]. 山东大学学报(医学版), 2014, 52(Z1): 164-165.
[10] 田玉泉. 4例恶性溃疡伤口的家庭护理[J]. 山东大学学报(医学版), 2014, 52(Z1): 183-184.
[11] 宋燕莹. 心血管介入术患者舒适护理进展[J]. 山东大学学报(医学版), 2014, 52(Z1): 204-205.
[12] 付晓荣. 循证护理干预对上消化道出血患者 情绪障碍和生活质量的影响[J]. 山东大学学报(医学版), 2014, 52(S2): 142-143.
[13] 赵宏宇,陈飞雪,曹静,戚庆庆,李月月,左秀丽,李延青. 脑组织海马区脑源性神经营养因子在焦虑调节内脏高敏感中的作用[J]. 山东大学学报(医学版), 2014, 52(3): 33-36.
[14] 丘雨蓓, 吴耀辉, 樊彦妮, 郭伟忠, 彭佳梅, 任会萍. 福州地区大学生牙科焦虑症与艾森克人格的相关性[J]. 山东大学学报(医学版), 2014, 52(12): 103-106.
[15] 韩杰1,刘亦青1,任妍妍2,栾德恒1,高昆1,解凤阳1. 三叉神经痛大鼠脑内P物质及β-内啡肽的变化[J]. 山东大学学报(医学版), 2013, 51(8): 45-48.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!