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目的:总结射频温控热凝术治疗648例原发性三叉神经痛患者的疗效和体会,探讨射频温控热凝术的方法、技巧和手术并发症的处理。方法:对2001年7月—2011年3月在我院分别采用眶下孔入路法、侧入路法、前入路法和其他入路进行射频治疗的648例原发性三叉神经痛患者临床疗效进行分析。结果:648例原发性三叉神经痛患者接受射频治疗,首次止痛率分别为眶下孔法98.3%、侧路法91.0%、前路法95.5%,首次射频治疗总有效率为96.0%,经6个月～2 a随访到的395例患者中,1年内复发率为9.6%,2年内复发率为20.5%,经再次射频治疗或手术治疗均获得完全止痛。结论:射频治疗原发性三叉神经痛疗效可靠,操作简便、适应证广、并发症较少,CT定位能提高穿刺精确度,减少并发症。
OBJECTIVE: To summarize the efficacy and experience of radiofrequency thermocoagulation in the treatment of 648 patients with primary trigeminal neuralgia and to discuss the methods, techniques and complications of radiofrequency thermocoagulation. Methods: A total of 648 patients with primary trigeminal neuralgia undergoing radiofrequency ablation of the infraorbital foraminotomy, lateral approach, anterior approach, and other approaches were performed in our hospital from July 2001 to March 2011. Clinical efficacy analysis. Results: 648 patients with primary trigeminal neuralgia underwent radiofrequency ablation. The first pain-relief rates were 98.3% for infraorbital foramen, 91.0% for lateral approach, 95.5% for anterior approach, and 96.0% for first-time RFA. Of the 395 patients who were followed up from 6 months to 2 years, the recurrence rate was 9.6% within 1 year and 20.5% within 2 years. Complete analgesia was obtained after radiofrequency ablation or surgery. Conclusion: Radiofrequency treatment of primary trigeminal neuralgia has the advantages of reliable curative effect, simple and convenient operation, wide indications and few complications. CT localization can improve puncturing accuracy and reduce complications.