三叉神经微血管减压术的疗效分析

目的 探讨原发性三叉神经痛患者行微血管减压术的治疗效果及并发症产生的相关因素。 方法 回顾性分析本院收治的30例原发性三叉神经痛并行三叉神经微血管减压术患者的相关临床资料。 结果 26例患者经微血管减压术治疗后疼痛完全缓解，总体有效率86.67%。术中见责任血管为小脑上动脉14例，小脑前下动脉7例，岩上静脉及其分支6例，3例患者术中未见明确责任血管；术后并发症：低颅压5例，脑脊液鼻漏1例。平均随访（20.53±12.41）个月，复发率为3.33%（1/30）。 结论 原发性三叉神经痛手术操作较易掌握，复发率低。小脑上动脉与小脑前下动脉是最常见的责任血管，术中应仔细辨认责任血管并对三叉神经充分减压，术后应注意低颅压及脑脊液漏等并发症的发生。

Efficacy analysis of microvascular decompression for primary trigeminal neuralgia

Objective To investigate the therapeutic effect of microvascular decompression(MVD) for the patients with primary trigeminal neuralgia(PTN) and related factors leading to postoperative complications.Methods The clinical data of 30 patients undergoing MVD for PTN in our hospital were retrospectively analyzed.Results The pain of 26 patients was completely relieved after the procedure of MVD, and the overall remission rate was 86.67%. The compressive vessels confirmed during the procedure were superior cerebellar arteries(SCAs)（14/30), anterior inferior cerebellar arteries (AICAs) (7/30), superior petrosal veins(SPVs) and its branches（6/30). Neurovascular compression absence was found in 3 cases. In terms of complications, low intracranial pressure syndrome occurred in 5 cases postoperatively and cerebrospinal fluid rhinorrhea was found in 1 case. Recurrence rate was 3.33%(1/30) during an average follow-up of (20.53±12.41) months.Conclusion MVD is a convenient and effective strategy for PTN patients with a low rate of recurrence. SCAs and AICAs are the most common responsible vessels. The responsible vessels should be carefully identified and the trigeminal nerve should be decompressed totally. Postoperative complications such as low intracranial pressure syndrome and cerebrospinal fluid rhinorrhea should be avoided.