摘要 目的 提出微血管减压术是治疗原发性三叉神经痛的最佳手术方式。 方法 报告了12例原发性三叉神经痛患者行微血管减压术，其中11例发现三叉神经入脑干区动脉压迫神经根，将压迫血管与神经根分离，在其间植入纤维蛋白海绵或聚四氟乙烯片维持分离状态，术后除1例疼痛减轻外，其余疼痛完全缓解，另1例术中未发现责任血管，但在神经根远侧段发现有粘连，将粘连松解，使神经根游离。 结果 所有患者术后疼痛减轻或缓解，所有病例无并发症。 结论 微血管减压术治疗原发性三叉神经痛是去除病因的手术方式，对已行微血管减压术后复发的患者再次行微血管减压术亦可获得满意疗效，作者还认为，神经内镜辅助微血管减压术顺应了当今微侵袭外科的趋势，将有望被更多地用来治疗原发性三叉神经痛。
Abstract Objective To propose that microvascular decompression is an optimal operation for idiopathic trigeminal neuralgia. Methods A total of 12 patients with idiopathic trigeminal neuralgia who underwent microvascular decompression were reported. Roots of nerve were compressed by arteries at root entry zone in 11 cases and all compressed were separated from offending vessels. Fibrin sponge or Teflon felt was interposed between each root and offending vessels and the separation was maintained. All patients obtained complete relief from pain after operation except for one patient with just reduction of pain. No abnormal vessel was found in the other one, however, adhesion was found at the distant segment of the root and it was loosened to set the root free. Results All patients had got postoperative relief from pain. No complications occurred in all cases. Conclusion Microvascular decompression for patients with idiopathic trigeminal neuralgia is by far the operation superior to others which wipes off pathogeny. Remicrovascular decompression for patients who accepted the first microvascular decompression can also achieve satisfactory outcome. It is also considered that endoscope assisted microvascular decompression is consistent with the trend of current microinvasive surgery and will be hopefully applied to more patients with idiopathic trigeminal neuralgia. |
