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目的 探讨伽码刀治疗原发性三叉神经痛的疗效 ,疗效与剂量关系。方法 采用OUR -XGD/B型旋转式伽玛刀Leksell-G型立体定位仪 ,1 0TMRI扫描定位 ,Gamma -TPS规划系统 ,在痛侧三叉神经根部 ,用 4mm准直器 ,布 1～ 2靶点中心 ,中心剂量为 80～ 1 0 0Gy。结果 2 2例获得随访 3 5～ 32 5个月 (平均 1 9 6个月 )。整剂量组平均缓解时间 1 1 5天 ,90～ 1 0 0Gy剂量组疼痛缓解时间明显缩短 (平均 2 6天 ) ,中心剂量 90～ 1 0 0Gy组与其他剂量组不良反应没有明显差异 (P <0 0 5)。 59 1 %患者疼痛完全缓解 ,2 2 7%患者疼痛缓解 >90 % ,9 1 %患者疼痛缓解 >50 % ,总有效率 (90 9% )。结论 伽码刀治疗原发性三叉神经痛是一种安全有效的方法 ,治疗中心剂量一般考虑为 90～ 1 0 0Gy。
Objective To investigate the curative effect of Gamma Knife on primary trigeminal neuralgia and its relationship with dose. Methods The Ortho-XGD / B rotating gamma knife Leksell-G stereotaxic instrument, 10 TMRI scanning and positioning system and Gamma-TPS planning system were used. On the pain-side trigeminal nerve root, Point center, the center dose of 80 ~ 100Gy. RESULTS: Twenty-two patients were followed up for 35-525 months (mean, 196 months). In the whole dose group, the average remission time was 115 days, the pain relief time was significantly shortened in the 90 ~ 100 Gy group (mean, 26 days), and there was no significant difference in adverse reactions between the central dose 90 ~ 100 Gy group and other dose groups (P < 0 0 5). 59% of the patients had complete remission of pain, 227% of the patients had pain relief> 90%, 91% of the patients had pain relief> 50% and the total effective rate was 90%. Conclusion Gamma knife treatment of primary trigeminal neuralgia is a safe and effective method, the treatment center dose is generally considered 90 ~ 100 Gy.