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目的探讨伽玛刀治疗老年原发性三叉神经痛的疗效及安全性。方法 118例三叉神经痛患者接受治疗,年龄65～88岁,平均71.6岁。使用美国GE 3.0T MRI定位,国产OUR-XGD型旋转式头部伽玛刀治疗,照射靶点为三叉神经根入桥脑处,采用4mm准直器,设2个等中心点,中心剂量70～75Gy,脑干边缘剂量12～15Gy。结果随访时间24～60个月,平均随访36个月,治愈78例,疗效显著33例,无效7例,总有效率(治愈+显著)94%,无近期急性并发症,无明显远期并发症。结论伽玛刀治疗老年原发性三叉神经痛安全有效,对药物等保守治疗无效的顽固性三叉神经痛患者可行伽玛刀治疗。
Objective To investigate the efficacy and safety of Gamma Knife in the treatment of senile primary trigeminal neuralgia. Methods A total of 118 patients with trigeminal neuralgia underwent treatment, aged from 65 to 88 years, with an average of 71.6 years. US GE 3.0T MRI positioning, domestic OUR-XGD rotary head gamma knife treatment, irradiation target for the trigeminal nerve root into the bridge at the brain, the use of 4mm collimator, set 2 isocenters, the central dose of 70 ~ 75Gy, brainstem edge dose 12 ~ 15Gy. Results The follow-up time ranged from 24 months to 60 months. The patients were followed up for an average of 36 months. 78 cases were cured. There were 33 cases with significant curative effect and 7 cases with ineffectiveness. The total effective rate (cure + significant) 94%, no recent acute complications, disease. Conclusion Gamma knife is safe and effective in the treatment of senile primary trigeminal neuralgia. It can be used to treat refractory trigeminal neuralgia patients who are ineffective in the conservative treatment of drugs.