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] 冯雅妮,牛晓欣,麻莉娜,施叶雯,苏永龙,谢雨杉,袁钰淇,朱思敏,周雅诺,刘郝羽,刘海琴,任晓勇. 阻塞性睡眠呼吸暂停患者过度嗜睡严重程度与焦虑抑郁的相关性:一项大样本临床研究[J]. 山东大学学报 (医学版), 2026, 64(1): 19-27.
[2] 孙利静,孟月茹,张召义,刘蕾,马丽瑾,房鹛. 反复种植失败患者焦虑抑郁症状与情绪调节策略的相关性研究[J]. 山东大学学报 (医学版), 2025, 63(10): 89-97.
[3] 王婷,张丽,王刚. 神经心理性哮喘[J]. 山东大学学报 (医学版), 2024, 62(5): 28-34.
[4] 梁原浩,肖文珊,彭盛昕,张翼翔,师彬,于功昌,刘垒. CT重建下经侧入路卵圆孔穿刺入路建立及其应用[J]. 山东大学学报 (医学版), 2024, 62(5): 95-102.
[5] 王新起,徐晶晶,许旺旺,张洋,高进. 25(OH)D、IGF-I及焦虑、抑郁症状与门诊青少年精神障碍患者非自杀性自伤的关系[J]. 山东大学学报 (医学版), 2024, 62(12): 59-64.
[6] 张恒哲,侯晓慧,Arezou Bikdeli,李大庆. 152例非急性心肌梗死患者完全血运重建介入治疗后疲劳程度的影响因素[J]. 山东大学学报 (医学版), 2023, 61(7): 47-54.
[7] 钱明,姜雷,王学建,赵伟,汪志峰,张毅. 神经内镜与钻孔引流治疗大量慢性硬膜下血肿的疗效及安全性[J]. 山东大学学报 (医学版), 2023, 61(12): 94-99.
[8] 孙富云,王维鹏,张会会,耿艳,安小霞,李双双,张彬彬. 结直肠癌术后患者人格特质与抑郁、焦虑症状的关联性[J]. 山东大学学报 (医学版), 2021, 59(7): 91-96.
[9] 刘静,袁中尚,李秀君,孙秀彬,马絮飞,赵秀兰. “以学生为中心”理念指导下的《医学统计学》教学综合改革与探索[J]. 山东大学学报 (医学版), 2021, 59(7): 119-124.
[10] 王亮亮,张铭,孙振伟,丁守銮,樊跃飞,王成伟. 伽玛刀与微血管减压术治疗原发性三叉神经痛的疗效比较[J]. 山东大学学报 (医学版), 2021, 59(1): 28-33.
[11] 石飞,潘翔,杨见明. 106例甲状腺乳头状癌患者行甲状腺全切手术后生存质量分析[J]. 山东大学学报 (医学版), 2020, 58(5): 87-92.
[12] 池岩娜,刘西瑶,巨艳丽,尹周一,Bob Lew,贾存显. 焦虑抑郁压力量表在医学生中的信效度检验[J]. 山东大学学报 (医学版), 2019, 57(9): 114-118.
[13] 孙瑶瑶,刘菲,曹枫林. 三甲医院医护人员职业倦怠亚型及情绪问题研究[J]. 山东大学学报 (医学版), 2019, 57(6): 100-105.
[14] 刘斌,田海龙,危兆胜,洪涛,王志刚. 神经内镜下扩大经鼻蝶手术颈内动脉破裂2例报道并文献复习[J]. 山东大学学报 (医学版), 2019, 57(2): 120-124.
[15] 赵可通,赵静,Aiyelabowo Faith,王颖. 植入心脏永久起搏器对缓慢性心律失常并发焦虑或抑郁的影响[J]. 山东大学学报 (医学版), 2018, 56(7): 39-45.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!