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目的探讨CT引导下经皮穿刺颅外非半月节射频热凝治疗原发性三叉神经痛的护理方法。方法回顾性总结并分析2013年1月—2015年6月嘉兴市第一医院疼痛科采用CT引导下经皮穿刺眶上孔、圆孔、卵圆孔行颅外非半月节射频热凝治疗的218例原发性三叉神经痛患者的临床操作及护理资料,重点关注术前护理准备、术中护理配合和术后护理观察与处理,以总结最佳护理方案,提高治疗效果和患者的就医满意度。结果 218例原发性三叉神经痛患者中,第Ⅰ、Ⅱ、Ⅲ支分别为17例、89例、74例,Ⅰ+Ⅱ支、Ⅱ+Ⅲ支分别为13例、25例,分别接受了CT引导下经皮穿刺眶上孔、圆孔、卵圆孔及眶上孔+圆孔、圆孔+卵圆孔行颅外非半月节射频热凝治疗,其中215例1次治愈,3例有疼痛残留,再次射频后治愈,但原疼痛区均有不同程度感觉麻木,第Ⅲ支射频热凝后遗留不同程度的张口困难。术后发生面部肿胀29例,术后护理观察及时发现,经序贯冷、热敷处理后肿胀消退;所有患者均无损伤三叉神经非疼痛分支及其他并发症的情况发生。结论 CT引导下颅外非半月节射频热凝治疗三叉神经痛镇痛效果确切,并发症仅为面部肿胀和原疼痛区感觉麻木,术前针对性的心理护理及充分的术前准备,术中的监测、给药和术后病情观察与健康宣教是患者得到有效治疗和提高患者就医满意度的重要保证。
Objective To investigate the nursing of primary trigeminal neuralgia treated with percutaneous transcranial radiofrequency thermocoagulation under CT guidance. Methods Retrospectively reviewed and analyzed the results of retrospective study on the frequency of extracranial radiofrequency thermocoagulation by percutaneous transfraction of the orbital superior foramen, foramen ovale and foramen ovale under the guidance of CT in the Department of Pain, the First Affiliated Hospital of Jiaxing from January 2013 to June 2015. 218 cases of primary trigeminal neuralgia patients with clinical operation and nursing information, focusing on preoperative nursing preparation, intraoperative nursing and postoperative nursing observation and treatment to sum up the best nursing program to improve the treatment and patient satisfaction degree. Results Among 218 patients with primary trigeminal neuralgia, 17 cases were in group Ⅰ, 89 cases in group Ⅱ, 74 cases in group Ⅱ, and 13 cases in group Ⅱ + Ⅲ and 25 cases in group Ⅱ + Ⅲ, respectively CT-guided percutaneous supraorbital foramen, orbital foramen, foramen ovale and supraorbital hole + round hole, round hole + foramen ovale were treated with radiofrequency ablation of extracranial non- There are painful residuals, which are cured after radiofrequency again. However, the original pain areas all feel numbness in varying degrees. The third radiofrequency radiofrequency thermocoagulation left some degree of difficulty in opening the mouth. Postoperative facial swelling in 29 cases, postoperative care and timely observation found that after sequential cold, heat treatment swelling subsided; all patients without damage to the non-painful trigeminal nerve branches and other complications occurred. Conclusion CT-guided radiofrequency thermocoagulation for extrahepatic non-semilunar radiotherapy is effective in the treatment of trigeminal neuralgia. The complications are only facial swelling and numbness in the original pain area. Preoperative psychological nursing and sufficient preoperative preparation are also available. Intraoperatively The monitoring, administration and observation of postoperative illness and health education are important guarantees for patients to get effective treatment and improve the patient’s medical satisfaction.