原发性三叉神经痛的病因及显微血管减压治疗(附91例临床分析)

目的探讨原发性三叉神经痛病因及显微血管减压治疗的手术技巧。方法回顾性分析显微血管减压术治疗的91例原发性三叉神经痛病例资料。结果三叉神经入脑干区有血管压迫者89例。术后疼痛立即消失或显著减轻者78例,1周内明显减轻者11例。随访3~48个月(平均32个月),疼痛消失86例(94.5%),明显缓解、服得理多能够控制满意者5例,无复发病例。结论三叉神经入脑干区血管压迫是原发性三叉神经痛的常见病因。显微血管减压术是有效的治疗方法。准确判定责任血管并采取适当材料及方法使入脑干区减压是提高有效率,减少复发的主要措施。

Etiopathogenisis and treatment by microvascular decompression of idiopathic trigeminal neuralgia

Objective To study the etiopathogenisis of idiopathic trigeminal neuralgia (TN) and the technique of microvascular decompression(MVD).Methods Retrospectively analysised the data of 91 patients with idiopathic TN treated by MVD.Results The root entry zoon (REZ) of the trigeminal nerves were found compressed by vasculars in 89 cases.78 cases were pain free or relieving immediately after operation,11 cases relieved during the first week after operation.All the patients were followed up for 3 to 48 months (mean = 32ms),86 of them were pain free,and 5 cases suffered from light pain which could be relieved by carbamazepine.There were no recurrenc.Conclusion The REZ of the trigeminal nerve compressed by vasculars is the common etiopathogenisises of idiopathic TN,and MVD is an effective process to treat it.To find the responsible vascular exactly and separate it from the REZ thoroughly are effective methods to raise cure rate and reduce recurrence rate.