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目的观察氢吗啡酮注射液联合丙泊酚注射液和射频毁损术治疗三叉神经痛的临床疗效及安全性。方法将92例原发性三叉神经痛患者随机分为对照组46例和试验组46例。对照组予以5 mg·kg~(-1)丙泊酚注射液,静脉滴注+射频毁损术;试验组予以氢吗啡酮注射液20 mg·mL~(-1),静脉滴注,15 min后予以5 mg·kg~(-1)丙泊酚注射液,静脉滴注,+射频毁损术。比较2组患者的临床疗效、术中和术后的疼痛视觉模拟量表(VAS)评分,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的优良率分别为91.30%(42例/46例)和73.91%(34例/46例),差异有统计学意义(P<0.05)。试验组术中和术后的VAS评分分别为(3.42±1.12)和(1.13±0.09)分,对照组术中和术后的VAS评分分别为(6.82±0.68)和(3.02±0.21)分,差异均有统计学意义(均P<0.05)。2组患者的药物不良反应以面部感觉丧失、咀嚼肌瘫痪、角膜反射消失和恶心呕吐为主,且试验组和对照组的药物不良反应发生率分别为15.22%和34.81%,差异有统计学意义(P<0.05)。结论氢吗啡酮注射液联合丙泊酚注射液和射频毁损术治疗三叉神经痛的临床疗效确切,其能显著减轻患者术中和术后疼痛,且安全性较高。
Objective To observe the clinical efficacy and safety of hydromorphone injection combined with propofol injection and radiofrequency ablation in the treatment of trigeminal neuralgia. Methods Ninety-two patients with primary trigeminal neuralgia were randomly divided into control group (46 cases) and experimental group (46 cases). The control group received 5 mg · kg ~ (-1) propofol injection, intravenous infusion + RFA. The experimental group was given hydromorphone 20 mg · mL -1 intravenously for 15 min After 5 mg · kg ~ (-1) propofol injection, intravenous drip, radiofrequency ablation. The clinical efficacy, intraoperative and postoperative pain visual analog scale (VAS) scores, and the incidence of adverse drug reactions were compared between the two groups. Results After treatment, the excellent and good rates of the experimental group and the control group were 91.30% (42 cases / 46 cases) and 73.91% (34 cases / 46 cases) respectively, the difference was statistically significant (P <0.05). The intraoperative and postoperative VAS scores of the experimental group were (3.42 ± 1.12) and (1.13 ± 0.09), respectively. The VAS scores of the control group were (6.82 ± 0.68) and (3.02 ± 0.21) The differences were statistically significant (all P <0.05). Two groups of patients with adverse drug reactions facial loss of expression, masticatory muscle paralysis, loss of corneal reflection and nausea and vomiting, and the experimental group and control group, the incidence of adverse drug reactions were 15.22% and 34.81%, the difference was statistically significant (P <0.05). Conclusion Hydromorphone injection combined with propofol injection and radiofrequency ablation for the treatment of trigeminal neuralgia has definite curative effect. It can significantly reduce intraoperative and postoperative pain and has higher safety.