多点射频微创治疗三叉神经痛的临床研究

doi:10.12016/j.issn.2096-1456.2016.02.002

口腔疾病防治 ›› 2016, Vol. 24 ›› Issue (2): 74-78.DOI: 10.12016/j.issn.2096-1456.2016.02.002

所属专题： 111

多点射频微创治疗三叉神经痛的临床研究

张清彬¹(),邓力¹,张颖¹,邓末宏²,常世民³,何霞¹

1.广州医科大学附属口腔医院·广州口腔疾病研究所·口腔医学重点实验室,广东广州(510140)
2.武汉大学口腔医院颞下颌关节外科
3.首都医科大学附属北京友谊医院口腔颌面外科

收稿日期:2015-09-08 修回日期:2015-09-30 出版日期:2016-02-20 发布日期:2016-02-20
通讯作者: 张清彬
作者简介:张清彬,男,山东莱芜人,教授,主任医师,博士后,研究生导师,广州医科大学附属口腔医院口颌面痛-颞下颌关节科主任,中华口腔医学会全科专业委员会常委,广东省医学会颌面-头颈外科学委员会委员,广东省医师协会人文医学委员会常委,广东省医院协会口腔医疗管理分会委员。2005年毕业于武汉大学,获口腔医学博士学位。2007年至2009年作为援外专家参加原卫生部组建的“中国医疗队”援助非洲;2010年至2011年在韩国首尔国立大学齿科研究所做博士后研究;2014年1月至今在解放军总医院(301医院)做博士后研究。临床主要从事口腔颌面外科常见病、多发病的诊断和治疗,尤其擅长颞下颌关节病的综合序列治疗和三叉神经痛的微创治疗。先后主持十余项省部级和校级课题,近年发表文章50余篇,其中以第一作者(通讯作者)发表SCI文章12篇。
基金资助:
广东省医学科研基金(A2013294)

Clinical study on trigeminal neuralgia treatment with minimally invasive multipoint radiofrequency thermalcoagulation

Qing-bin ZHANG¹(),Li DENG¹,Ying ZHANG¹,Mo-hong DENG²,Shi-min CHANG³,Xia HE¹

¹Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China

Received:2015-09-08 Revised:2015-09-30 Online:2016-02-20 Published:2016-02-20
Contact: Qing-bin ZHANG

摘要/Abstract

摘要：

目的观察三叉神经干及外周支多点射频热凝术治疗三叉神经痛的临床疗效。方法选取确诊为三叉神经痛的患者180例,按照随机原则将所有入选患者分为治疗组60例,对照组Ⅰ 60例,对照组Ⅱ 60例。治疗组行三叉神经干及外周支多点射频热凝术治疗,对照组Ⅰ行单纯三叉神经半月节射频热凝治疗,对照组Ⅱ行三叉神经干及外周支封闭治疗,治疗后随访24个月,对3组疗效进行对比分析。结果治疗组、对照组Ⅰ与对照组Ⅱ的总有效率分别为100%、100%、60%,治疗组术后疼痛程度视觉模拟评分结果与对照组Ⅰ差异无统计学意义(P>0.05),治疗组术后疼痛程度视觉模拟评分结果明显小于对照组Ⅱ,差异有统计学意义(P<0.05)。治疗组并发症比对照组Ⅰ少,治疗组与对照组Ⅰ在相同随访时间内复发率差异无统计学意义(P>0.05)。结论三叉神经干及外周支的多点射频热凝术治疗三叉神经痛疗效显著,微创,并发症少,复发率低,安全性高。

关键词: 三叉神经痛, 周围神经, 多点射频, 微创, 并发症

Abstract:

Objective To observe the clinical efficacy of multipoint radiofrequency thermal coagulation on trigeminal neuralgia management. Methods 180 patients diagnosed as primary trigeminal neuralgia were included in this study. The patients were randomly divided into three groups, 60 patients in treatment group, 60 patients in the first control group and 60 patients in second control group respectively. Multipoint radiofrequency ablation therapy was utilized in the treatment group, radiofrequency thermal coagulation therapy on trigeminal ganglion was applied in the first control group and patients in second control group were treated by nerve block therapy. Then the curative effect of the three groups after the treatment was compared and analyzed. Results To the curative effects, the VAS score showed insignificant difference between treatment group and the first control group (P>0.05), while an significant difference between treatment group and the second control group (P<0.05). To the complications concerned, higher occurrence was found in the first control group. There was no significant difference between the treatment group and the first control group in the recurrence rate (P>0.05). Conclusion The minimally invasive multipoint radiofrequency ablation on the treatment of trigeminal neuralgia has significant effect with fewer complications and higher patients safety.

Key words: Trigeminal neuralgia, Peripheral nerve, Multiple radiofrequency ablation, Minimally invasive, Complications

中图分类号:

R782

张清彬,邓力,张颖,邓末宏,常世民,何霞. 多点射频微创治疗三叉神经痛的临床研究[J]. 口腔疾病防治, 2016, 24(2): 74-78.

Qing-bin ZHANG,Li DENG,Ying ZHANG,Mo-hong DENG,Shi-min CHANG,Xia HE. Clinical study on trigeminal neuralgia treatment with minimally invasive multipoint radiofrequency thermalcoagulation[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2016, 24(2): 74-78.

图/表 6

参考文献 17

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组别	性别	年龄	疼痛侧	术前疼痛程度
	(男/女)	(岁)	(左/右)	VAS评分
治疗组	32/28	54±0.5	24/36	8.6±1.2
对照组Ⅰ	22/38	55±0.7	28/32	8.3±1.0
对照组Ⅱ	28/32	53±0.6	26/34	8.5±1.3
F值	1.709	1.628	1.866	1.114
P值	0.11	0.09	0.08	0.65

组别	性别	年龄	疼痛侧	术前疼痛程度
	(男/女)	(岁)	(左/右)	VAS评分
治疗组	32/28	54±0.5	24/36	8.6±1.2
对照组Ⅰ	22/38	55±0.7	28/32	8.3±1.0
对照组Ⅱ	28/32	53±0.6	26/34	8.5±1.3
F值	1.709	1.628	1.866	1.114
P值	0.11	0.09	0.08	0.65

组别	术后疼痛程度VAS评分
组别	术后 1 d	术后3个月	术后6个月	术后12个月	术后24个月
治疗组	0.9±0.3	1.5±0.6	1.3±0.4	1.9±0.4	1.8±0.6
对照组Ⅰ	0.9±0.2	1.6±0.2	1.8±0.6	1.5±0.3	1.6±0.5
对照组Ⅱ	3.2±1.1	3.6±1.5	4.3±1.8	5.2±2.3	5.7±2.8
F值	2.104	1.772	1.859	1.422	1.378
P值	0.03	0.02	0.03	0.01	0.01
P₁值	0.08	0.06	0.05	0.06	0.10
P₂值	0.03	0.02	0.01	0.03	0.03
P₃值	0.02	0.01	0.03	0.02	0.03

组别	术后疼痛程度VAS评分
组别	术后 1 d	术后3个月	术后6个月	术后12个月	术后24个月
治疗组	0.9±0.3	1.5±0.6	1.3±0.4	1.9±0.4	1.8±0.6
对照组Ⅰ	0.9±0.2	1.6±0.2	1.8±0.6	1.5±0.3	1.6±0.5
对照组Ⅱ	3.2±1.1	3.6±1.5	4.3±1.8	5.2±2.3	5.7±2.8
F值	2.104	1.772	1.859	1.422	1.378
P值	0.03	0.02	0.03	0.01	0.01
P₁值	0.08	0.06	0.05	0.06	0.10
P₂值	0.03	0.02	0.01	0.03	0.03
P₃值	0.02	0.01	0.03	0.02	0.03

多点射频微创治疗三叉神经痛的临床研究

Clinical study on trigeminal neuralgia treatment with minimally invasive multipoint radiofrequency thermalcoagulation

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