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目的:研究原发性三叉神经痛伽玛刀治疗的靶点—效应关系和剂量—效应关系。方法:对伽玛刀治疗的63例原发性三叉神经痛进行回顾性分析,对三叉神经半月节、三叉神经近端的靶点—效应和剂量—效应进行统计学处理。结果:63例经6～72个月,平均为36.74个月的随访,疼痛消失37例(58.73%),疼痛缓解90%以上12例(19.05%),缓解50%以上9例(14.29%),无效5例(7.93%),总有效率92.07%。治疗靶点选择三叉神经根近端的疗效对比三叉神经半月节有显著差异(P<0.05)。中心剂量120Gy与120Gy以下在疗效上有显著性差异(P<0.05)。结论:选择三叉神经根近端为靶点,中心剂量在120Gy是最佳治疗方案。同时三叉神经根在MRI上的长度对治疗效果有一定影响,如基底环Y轴按平行眦听线(CM)向前开放15度角的直线安装,则断层扫描可获得良好的神经全程显示效果。
Objective: To study the target-effect relationship and dose-response relationship of gamma knife treatment of primary trigeminal neuralgia. Methods: 63 cases of primary trigeminal neuralgia treated with gamma knife were retrospectively analyzed. The target - effect and dose - effect of the trigeminal nerve at the meniscus and the proximal trigeminal nerve were statistically analyzed. Results: 63 cases were followed up for 6 to 72 months with an average of 36.74 months. Pain disappeared in 37 cases (58.73%), pain relieved more than 90% in 12 cases (19.05%), relieved more than 50% in 9 cases (14.29% , Invalid in 5 cases (7.93%), the total efficiency of 92.07%. Therapeutic target selection of the proximal trigeminal nerve root compared to trigeminal nerve meniscus significant difference (P <0.05). Central dose 120Gy and 120Gy the following significant differences in efficacy (P <0.05). Conclusion: The selection of the proximal trigeminal nerve root as the target, the center dose of 120Gy is the best treatment. At the same time, the length of the trigeminal nerve root on the MRI has an effect on the treatment effect. For example, if the Y-axis of the base ring is installed straightly at a 15-degree angle toward the anterior (CM), the tomographic scan can obtain a good nerve full display effect .