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目的验证数字血管减影术定位在射频治疗三叉神经痛卵圆孔穿刺的临床价值及其治疗效果。方法66例三叉神经痛患者在数字血管减影术定位下行三叉神经痛射频热凝术治疗,计算球管角度及穿刺深度。射频毁损设定为目标温度85℃,120 s,对其治疗效果进行近期与远期评价。结果正位球管向患侧倾斜角度(19.8±3.5)度,向尾侧倾斜角度(28.8±6.5)度,侧位向左(或右)倾斜(88±4.5)度,向头倾斜(5.5±2.5)度。穿刺深度,第Ⅲ支平均0.46 cm,第Ⅱ支平均1.36 cm。66例患者穿刺成功率100%,术后疼痛即刻消失率100%,随访5个月-3年,3例复发,并发角膜炎2例,头痛5例,并发症发生率0.11%。结论数字血管减影术定位下穿刺卵圆孔,施行三叉神经射频治疗是治疗三叉神经痛的一种安全、准确、客观、效佳的方法。
Objective To verify the clinical value of digital angiography in radiofrequency treatment of foramen ovale of trigeminal neuralgia and its therapeutic effect. Methods Totally 66 patients with trigeminal neuralgia were treated with radiofrequency thermocoagulation of trigeminal neuralgia under digital angiography. The angle of tube and the depth of puncture were calculated. RF damage set to the target temperature of 85 ℃, 120 s, the treatment effect of short-term and long-term evaluation. Results The position of the globe tube was inclined to the affected side (19.8 ± 3.5) degrees, to the caudal side (28.8 ± 6.5) degrees, to the left (or right) side to the side (88 ± 4) .5) degrees, tilt to the head (5.5 ± 2.5) degrees. The depth of the puncture was 0.46 cm for the third branch and 1.36 cm for the second branch. The successful rate of puncture was 100% in 66 patients. The rate of immediate disappearance after operation was 100%. The patients were followed up for 5 months to 3 years. Three patients were relapsed with keratitis in 2 and headache in 5 patients. The complication rate was 0.11%. Conclusion digital angiography positioning foramen ovale, the implementation of trigeminal nerve radiofrequency treatment of trigeminal neuralgia is a safe, accurate, objective and effective method.