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目的观察CT引导下经皮卵圆孔穿刺,半月神经节注射乙醇或阿霉素毁损治疗三叉神经痛的效应。方法92例原发性三叉神经痛患者,男39例,女53例,年龄37-84岁,病程1-14年,随机分为2组。治疗前CT冠状及轴位扫描卵圆孔和颅后窝,除外继发性三叉神经痛。在穿刺卵圆孔过程中CT引导穿刺的方向并确认针尖的位置,经造影确保穿刺针准确位于神经节内,A组向三叉神经半月节注射神经破坏药乙醇,B组注射阿霉素。结果治疗后12个月,两组分别有31例和36例完全无痛,13例和6例未缓解,组间比较差异有统计学意义(P<0.05),两组均无严重并发症。结论CT引导下经皮半月神经节毁损术治疗三叉神经痛效果明显,阿霉素的疗效优于乙醇。
Objective To observe the effect of CT guided percutaneous foramen ovale puncture and the injection of ethanol or doxorubicin into the semilunar ganglion for the treatment of trigeminal neuralgia. Methods A total of 92 patients with primary trigeminal neuralgia, 39 males and 53 females, aged 37-84 years and having a duration of 1 to 14 years were randomly divided into two groups. Coronary and axial CT scan of the foramen ovale and posterior fossa before CT, except for secondary trigeminal neuralgia. During the process of puncturing the foramen ovale, CT guided the direction of the puncture and confirmed the position of the needle tip. The angiography was performed to ensure that the puncture needle was accurately located in the ganglion. Group A was injected with neurotoxic drug ethanol into the trigeminal nerve meniscus and group B was injected with doxorubicin. Results At 12 months after treatment, 31 cases and 36 cases were completely painless in both groups, and 13 cases and 6 cases did not relieve. The difference between the two groups was statistically significant (P <0.05). There was no serious complications in both groups. Conclusion The CT-guided percutaneous semilunar ganglionectomy is effective in treating trigeminal neuralgia. Adriamycin is more effective than ethanol.