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目的:对985例采用改良式射频温控热凝术治疗三叉神经痛病例资料进行总结。方法:用穿刺针经前路法穿刺,到达卵圆孔内三叉神经半月节感觉根,连接射频温控热凝仪及相配套电极,先进行方波定位刺激确认无误后,一次性快速加热至88℃左右,在感觉根的2～3个断面上热凝。结果:术后即刻疗效:优良率97.56%,无效0.41%;主要并发症:1例麻痹性角膜溃疡性失明;1例眶尖综合征合并急性闭角性青光眼。经5年随访227例,38例复发,复发率16.74%。结论:改良式射频温控热凝术治疗三叉神经痛具有传统射频治疗的优点,由于快速加热,可缩短患者在治疗过程的疼痛时间,减轻痛苦;多点热凝可提高即刻疗效;提高热凝温度至88℃可更彻底灼损神经纤维,对减少复发有一定作用。改良式射频温控热凝术治疗三叉神经痛可提高疗效、减少复发、减轻患者在治疗过程中的痛苦,而且安全可行。
OBJECTIVE: To summarize the data of 985 cases treated with modified radiofrequency thermocoagulation for trigeminal neuralgia. METHODS: The puncture needle was punctured by the anterior approach and reached the sensory root of the trigeminal nerve in the foramen ovale. The radiofrequency thermometer and the matching electrode were connected. After square-wave positioning stimulation was confirmed, the one-time rapid heating to 88 ℃ or so, in the feeling of root 2 ~ 3 cross-section of thermal coagulation. Results: The immediate postoperative curative effect was excellent and good rate was 97.56% and ineffective 0.41%. The main complication was one case of paralytic corneal ulcerative blindness and one case of orbital apex syndrome with acute angle closure glaucoma. After 5 years of follow-up 227 cases, 38 cases of recurrence, the recurrence rate was 16.74%. CONCLUSIONS: Modified RF thermocoagulation for the treatment of trigeminal neuralgia has the advantages of traditional radiofrequency ablation. Due to the rapid heating, patients can be relieved of pain during treatment and relieve pain. Multi-point thermocoagulation can improve immediate curative effect. Temperature to 88 ° C can more thoroughly burn nerve fibers, to reduce the recurrence of a certain role. Modified RF thermocoagulation in the treatment of trigeminal neuralgia can improve the curative effect, reduce the recurrence and relieve the patient’s pain in the course of treatment, and is safe and feasible.