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目的手术导致的感觉功能障碍是三叉神经痛(trigeminal neuralgia,TN)外科治疗的主要临床并发症之一。本研究运用一种新近发展的感觉功能定量检测技术-电流感觉阈值测量法(current perception threshold measurement,CPTM)系统地识别和评定TN的三种主要外科手术后的三叉感觉功能。方法 48例无外科治疗史的TN患者接受了以下三种外科治疗中的一种:微血管减压术(microvascular decompression,MVD)、周围神经酒精阻滞术(peripheral nerve block,PNB)和经皮射频热凝术(percutaneous radiofrequency thermocoagulation,PRFT),术前48小时和术后4周进行CPTM和传统定性感觉功能检测。结果非手术侧未发现有统计学变化,证实CPTM的可重复性。PNB和PRFT在各CPTM检测频率上均发现存在显著的术后感觉功能障碍,表明所有三种感觉纤维均存在损害。另一方面,MVD术后所有三种纤维的感觉功能均未发生变化。结论 CPTM是一种用于评估经过外科治疗后的三叉神经感觉功能的定量、准确和可重复的方法。所检测的三种主要外科手术中,仅MVD保留了三叉神经的感觉功能。
The purpose of surgical treatment of sensory dysfunction is trigeminal neuralgia (trigeminal neuralgia, TN) surgical treatment of one of the major clinical complications. This study systematically identified and assessed the three main trisomy sensory functions of TN by using a newly developed current sensing threshold quantification technique, current perception threshold measurement (CPTM). Methods Forty-eight TN patients without a history of surgical treatment underwent one of three surgical procedures: microvascular decompression (MVD), peripheral nerve block (PNB) and percutaneous radiofrequency Percutaneous radiofrequency thermocoagulation (PRFT), preoperative 48 hours and postoperative 4 weeks CPTM and traditional qualitative sensory function testing. Results There was no statistically significant change on the non-surgical side, confirming the repeatability of CPTM. PNB and PRFT found significant postsurgical sensory dysfunction at each CPTM detection frequency, indicating that all three sensory fibers were compromised. On the other hand, there was no change in the sensory function of all three fibers after MVD. Conclusion CPTM is a quantitative, accurate and reproducible method for assessing the sensory function of the trigeminal nerve after surgical treatment. Of the three major surgeries examined, only MVD retained the sensory function of the trigeminal nerve.