螺旋CT引导精确穿刺射频温控热凝术治疗经典型三叉神经痛的临床应用.pdf

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1、·682·徐州医学院学报ACTAACADEMIAEMEDICINAEXUZHOU2013，33(10)螺旋CT引导精确穿刺射频温控热凝术治疗经典型三叉神经痛的临床应用于勇，苏本玄，于骋，谢光彤，胡玫(1．丰县人民医院El腔颌面外科，江苏丰县221700；2．中国人民解放军第97医院烧伤整形科，江苏徐州221004；3．徐州医学院临床医学系2012级，江苏徐州221004；4．丰县人民医院螺旋cT室)摘要：目的探讨螺旋CT引导经卵圆孔穿刺射频温控热凝术治疗经典型三叉神经痛的快速精确穿刺方法。方法收治

2、确诊的经典型三叉神经痛57例，经螺旋cT引导定位，穿刺针经卵圆孔至三又神经半月神经节，进行射频温控热凝治疗。结果所有患者均在短时间内一次性穿刺成功，治疗后7天、3个月疼痛强度评分(NRS)均较术前明显降低(P<0．05)。三又神经痛完全缓解52例(91．23％)，明确缓解3例(5．26％)，中度缓解2例(3．51％)。无严重并发症。结论螺旋CT引导精确穿刺射频温控热凝术治疗经典型三叉神经痛，定位精确，穿刺快速，确保成功，避免了多次穿刺对针道周围组织的损伤。关键词：三叉神经痛；射频温控热凝术；断层摄

3、影术，x线计算机；卵圆孔穿刺中图分类号：R782．05文献标志码：B文章编号：1000—2065(2013)10—0682—03ClinicalapplicationofspiralCT—guidedprecisepunctureofforamenovaleforthetreatmentofclassicaltrigeminalneuralgiabyradiofrequencythermocoagulationYUYong，SUBenxuan，YUCheng，XIEGuangtong4，HUMei

4、(1．DepartmentofOralandMaxillofacialSurgery，FengxianCountyPeopleSHospital，FengxianCounty，Jiangsu221700，China；2．DepartmentofBurnandPlasticSurgery，The97thHospitalofPLA，Xuzhou，Jiangsu221004；3．Grade2012，DepartmentofClinicalMedicine，XuzhouMedicalCollege，Xuz

5、hou，Jiangsu221004；4．SpiralCTRoom，FengxianCountyPeopleSHospita1)Abstract：ObjectiveToinvestigatethefastandaccuratemethodofspiralCT—guidedforamenovale(FO)punc—tureforthetreatmentofclassicaltrigeminalneuralgiabyradiofrequencythermocoagulation．Mothods57cas

6、esofclassi—caltrigeminalneuralgiaweretreatedbyradiofrequencythermocoagulationtherapyusingspiralCT—guidedpositioningoftheneedlethroughtheFOtothetrigeminalganglion．ResultsSuccessfulFOpunctureatfirstattemptwasperformedinashorttimeonallpatients．TheNumeric

7、RatingScale(NRS)at7daysand3monthsafterthetreatmentwassignificant—lylowerthanbeforeoperation(P<0．05)．Completepainreliefwasaccomplishedin52cases(91．23％)，clearpainreliefin3cases(5．26％)，moderatepainreliefin2cases(3．51％)．Noseriouscomplicationswereobserved．

8、Conclu-sionSpiralCT——guidedpreciseFOpunctureforthetreatmentofclassicaltrigeminalneuralgiabyradiofrequencyther·-mocoagulationhastheadvantageofaccuratepositioningandfastpuncturewithhighsuccessrate，SOitcanavoiddamagetothesurroundingtissueofthenee