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目的研究伽玛刀放射外科治疗复发性三叉神经痛的有效性和安全性。方法回顾性分析对曾经接受过微血管减压术(MVD),伽玛刀放射外科(GKRS),射频(RF)或封闭治疗后疼痛复发的患者59例,并与同期未行上述治疗的28例患者进行对比分析,评价患者经GKRS治疗后的疼痛控制率及并发症发生率。结果伽玛刀治疗后平均随访时间33个月(8~62个月)。疼痛控制有效率在MVD组为69.2%;GKRS复发组为83.3%;RF组为87.5%;封闭组为75.0%;GKRS组为89.3%;各组之间无统计学差异(P=0.516)。面部感觉异常发生率在MVD组为15.4%;GKRS复发组为33.3%;RF组为25.0%;封闭组为25.0%;GKRS组为14.3%;各组之间无统计学差异(P=0.579)。结论伽玛刀放射外科治疗三叉神经痛疗效确切,不良反应发生率低,是TN复发患者的较好的治疗方式。
Objective To study the efficacy and safety of gamma knife radiosurgery in the treatment of recurrent trigeminal neuralgia. Methods Fifty-nine patients with recurrent pain after microvascular decompression (MVD), gamma knife radiosurgery (GKRS), radiofrequency (RF) or closed therapy were retrospectively analyzed and compared with 28 patients who did not receive the above treatment during the same period Patients were compared and analyzed to evaluate the pain control rate and complication rate after GKRS treatment. Results The average follow-up time of gamma knife treatment was 33 months (range, 8 to 62 months). The effective rate of pain control was 69.2% in MVD group, 83.3% in GKRS recurrence group, 87.5% in RF group, 75.0% in blocking group, and 89.3% in GKRS group. There was no significant difference between the two groups (P = 0.516). The incidence of facial sensation was 15.4% in the MVD group, 33.3% in the GKRS recurrence group, 25.0% in the RF group, 25.0% in the GKRS group and 14.3% in the GKRS group. There was no significant difference between the groups (P = 0.579) . Conclusion Gamma knife radiosurgery is effective in treating trigeminal neuralgia and has a low incidence of adverse reactions. It is a good treatment for patients with TN recurrence.