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目的:通过与Hartel前入路行射频热凝术对比,观察CT定位下经眶-圆孔入路行射频热凝术治疗三叉神经痛第Ⅱ支病变的临床效果。方法:选取40例单纯三叉神经第Ⅱ支病变患者,分为眶-圆孔入路组(n=20)和Hartel前入路组(n=20),在CT定位下,眶-圆孔入路组穿刺圆孔,Hartel前入路组穿刺卵圆孔,以方波电刺激判断和确定穿刺针针尖位置,确认无误后,行射频温控热凝治疗,对比两种方法的手术过程、临床效果和术后并发症。结果:术后两组患者三叉神经疼痛症状均立即缓解,术后6个月疼痛缓解效果相同(P>0.05),与Hartel前入路组相比,眶-圆孔入路组手术时间缩短,由于非特异性阻滞了第Ⅲ支和第Ⅰ支引起的术后咀嚼无力和角膜受累的并发症减少(P<0.05)。结论:在CT定位下选择性阻滞三叉神经第Ⅱ支,眶-圆孔入路经皮穿刺射频热凝治疗具有更高的特异性,同时可缩短手术时间,减少并发症的发生,患者满意度更高。
OBJECTIVE: To compare the clinical results of radiofrequency thermocoagulation with Hartel anterior approach radiofrequency thermocoagulation for the treatment of the second trigeminal neuralgia by CT orbital-circular approach. Methods: Forty patients with simple trigeminal trigeminal trigeminal disease were divided into two groups: orbital foramen omentum group (n = 20) and Hartel anterior approach group (n = 20) Road puncture the hole, Hartel anterior approach group of foramen ovale to square wave stimulation to determine and determine the location of the needle tip to confirm the correct after radiofrequency thermocoagulation treatment, compared with the two methods of surgery, clinical Effect and postoperative complications. Results: Trigeminal nerve pain relieved immediately after operation in both groups, and the pain relief effect was the same at 6 months after operation (P> 0.05). Compared with Hartel anterior approach group, operation time in orbital - Due to non-specific block of the first branch and the first branch caused by postoperative chewing weakness and corneal involvement of the complications decreased (P <0.05). CONCLUSION: The selective treatment of the second branch of the trigeminal nerve by CT and the radiofrequency thermocoagulation by orbital-circular approach have higher specificity and can shorten the operation time and reduce the incidence of complications. The patients are satisfied Degree is higher.