射频热凝与伽玛刀治疗原发性三叉神经痛的疗效比较

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Abstract Objective To compare the therapeutic efficacy of stereotactic radiofrequency thermocoagulation(RF) and Gamma knife radiosurgery (GKS) for the treatment of trigeminal neuralgia(TN).Methods The treatment outcomes of 46 patients with TN were analyzed retrospectively. 21 of them underwent RF treatment and the rest underwent GKS treatment. The pain control rate,complications and recurrence were used to assess the therapeutic effect.Results The mean follow-up time was 25.6 months (ranged from 12 to 36 months).According to barrow neurological institute (BNI) pain scale, RF group had 17 cases of grade Ⅰ,2 cases of grade Ⅱ,1 case of grade Ⅲ, and 1 case of Ⅳ-Ⅴ. 20 cases of grade I to III were effective. In the GKS group, there were 12 cases of grade Ⅰ,4 cases of of grade Ⅱ,6 cases of grade Ⅲ, and 3 cases of Ⅳ-Ⅴ, so 22 cases were effectively treated. There were more cases of grade Ⅰ in the RF group than in the GKS group, and the difference was statistically significant. The effective rate was not statistically significant between grade II and grade III. The incidence of facial numbness in the RF group was significantly higher than that of the GKS group, but there was no statistically significant difference in the decline of masticatory muscle strength, angular salivation or keratitis. One case of recurrences was seen in both groups.Conclusions Both RF and GSK can obviously relieve pain in TN patients. RF treatment has quick effect and brings about quick recovery but it can induce complications. GKS treatment is non-invasive and safe, with fewer complications , but is slow to produce effect.

Key words： trigeminal neuralgia radiofrequency thermocoagulation Gamma knife radiosurgery

Received: 10 January 2018

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2018/V29/I5/456

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