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目的 :经随机双盲对照分析,对经翼腭窝与经卵圆孔上颌神经射频热凝术治疗三叉神经痛进行临床疗效比较。方法 :2004年1月-2008年6月,50例顽固性三叉神经上颌支疼痛患者被纳入,并且随机分成A、B两组。分别在数字减影血管造影(digital subtraction angiography,DSA)介导下进行经翼腭窝(A组)或经卵圆孔(B组)上颌神经射频热凝术。利用视觉模拟评分法(visual analoguescores,VAS)、患者满意度评分(patient satisfaction score,PSS)进行术前与术后不同时段疗效评定。同时记录手术副作用、并发症发生情况及复发率。随访时间为24个月。结果 :经翼腭窝与经卵圆孔上颌神经射频热凝术治疗三叉神经痛,术后VAS评分均明显下降(P<0.05),术后患者满意度高。术后临床疗效、副作用和术后复发率,两组患者相比无明显差异。在并发症方面,经翼腭窝组少于卵圆孔组(P<0.05)。结论 :经翼腭窝与经卵圆孔上颌神经射频热凝术相比,两者均具有定位确切、操作方便和有优良的临床疗效,但前者手术并发症较少于后者。
OBJECTIVE: To compare the clinical efficacy of maxillary nerve radiofrequency thermocoagulation in the treatment of trigeminal neuralgia by means of a pterygopalatine fossa with a randomized double-blind comparative analysis. METHODS: From January 2004 to June 2008, 50 patients with intractable maxillary trigeminal pain in trigeminal nerve were included and randomly divided into A and B groups. Maxillary nerve radiofrequency thermocoagulation in the pterygopalatine fossa (group A) or foramen ovale (group B) was performed under digital subtraction angiography (DSA). The visual analogue scale (VAS) and patient satisfaction score (PSS) were used to assess the curative effect at different time points before and after operation. At the same time record the side effects of surgery, complications and recurrence rate. Follow-up time was 24 months. Results: The trigeminal neuralgia treated by pterygopalatine fossa and maxillary nerve radiofrequency through the foramen ovale showed a significant decrease in postoperative VAS score (P <0.05). The postoperative satisfaction was high. Postoperative clinical efficacy, side effects and postoperative recurrence rate, no significant difference between the two groups of patients. In complication, the pterygopalatine fossa group was less than the foramen ovale group (P <0.05). Conclusion: Compared with maxillary nerve radiofrequency thermocoagulation through the foramen ovale, both of them have the advantages of exact location, convenient operation and excellent clinical curative effect. However, the former has fewer complications than the latter.