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目的:评价磁共振体层血管成像(MRTA)对预测三叉神经痛患者微血管减压术(MVD)后疗效的价值。方法 :277例行MVD的三叉神经痛患者手术前、后接受MRTA检查,由2名影像医师分别读取术前及术后NVC分级,术后疗效分为优、良和差3组,采用SPSS 13.0软件包中的χ2检验确定术前NVC的压迫程度、术后NVC压迫程度和术后NVC的缓解度在3组的分布有无差异。结果:250例(90.2%)病例术后2年疗效为优,18例(6.5%)为良,8例(2.9%)为差,1例(0.4%)因术后颅内出血死亡。术前不同NVC分级的病例,术后疗效无显著差异(χ2=5.542,P=0.476);术后不同NVC分级(χ2=18.693,P<0.05)和不同NVC缓解度(χ2=11.484,P<0.05)的病例,术后疗效有显著差异。结论:MVD术后行MRTA检查,是预测术后疗效较为有效的方法之一,术后NVC分级越大和NVC缓解度越小的病例,MVD术后疼痛缓解不佳的可能性越高。
Objective: To evaluate the value of magnetic resonance tomography (MRTA) in predicting the efficacy of microvascular decompression (MVD) in patients with trigeminal neuralgia. METHODS: Totally 277 patients with trigeminal neuralgia undergoing MVD underwent MRTA before and after surgery. Two preoperative and postoperative NVC were read by two imaging doctors. The postoperative outcomes were divided into three groups, excellent, poor and poor. The patients were treated with SPSS 13.0 Χ2 test in the software package to determine the degree of preoperative NVC compression, postoperative NVC compression and postoperative NVC remission in the distribution of the three groups with or without any difference. Results: Two years after operation, 250 cases (90.2%) had excellent curative effect, 18 cases (6.5%) were good, 8 cases (2.9%) were poor and 1 case (0.4%) died after intracranial hemorrhage. There was no significant difference between the two groups (χ2 = 5.542, P = 0.476), postoperative NVC grading (χ2 = 18.693, P <0.05) and different NVC remission (χ2 = 11.484, P < 0.05) cases, there are significant differences in postoperative efficacy. Conclusion: MRTA examination after MVD is one of the most effective methods for predicting the postoperative curative effect. The higher the grade of postoperative NVC and the lesser NVC, the higher the possibility of postoperative pain relief after MVD.