论文部分内容阅读
目的提出导致脑神经疾病的责任血管的分型标准,总结处理不同类型责任血管的经验教训。方法根据责任血管与脑神经的关系,将责任血管分为非贯穿型、贯穿型和混合型。对非贯穿型,将血管与脑神经分开;对贯穿型,以血管为起点沿长轴分开神经根,将血管推向脑神经根远端;对混合型,一般先处理非贯穿型的血管,再处理贯穿型血管。最后行围套式微血管减压。结果983例三叉神经痛患者,术后969例疼痛立即消失,14例疼痛明显减轻;279例面肌痉挛患者,术后225例痉挛立即消失,54例不同程度减轻;33例舌咽神经痛患者,术后32例疼痛立即消失,1例明显减轻。1097例得到随访,术后一年以上复发29例(2.64%)。结论充分认识各型责任血管的存在,正确进行责任血管的分型,重视并采取正确的方法处理各型责任血管,将有助于提高微血管减压术治疗脑神经疾病的有效率,减少并发症,降低复发率。
OBJECTIVE: To propose criteria for the classification of responsible blood vessels leading to cranial nerve diseases and to summarize the experiences and lessons learned in handling different types of responsible blood vessels. Methods According to the relationship between responsible vessels and cranial nerves, the responsible vessels were divided into non-penetrating type, penetrating type and mixed type. For non-penetrating type, the blood vessels and cranial nerves are separated; for the penetrating type, the nerve roots are separated along the long axis starting from the blood vessel, and the blood vessels are pushed to the distal end of the cranial nerve root; for the mixed type, generally the non-penetrating blood vessels are treated first, Re-treatment through the blood vessels. The last line of microcirculation microvascular decompression. Results In 983 patients with trigeminal neuralgia, pain disappeared immediately after operation in 969 patients and pain was relieved in 14 patients. In 279 patients with hemifacial spasm, 225 patients with spasticity immediately disappeared and 54 patients were relieved to varying degrees; 33 patients with glossopharyngeal neuralgia , 32 cases of pain immediately disappeared, 1 case was significantly reduced. 1097 cases were followed up, 29 cases (2.64%) relapsed more than one year after operation. Conclusions It is helpful to fully understand the existence of various responsible vessels, correctly classify responsible vessels, and take proper measures to deal with various types of responsible vessels. This will help to improve the efficiency of microvascular decompression in treating neurological diseases and reduce the complications , Reduce the recurrence rate.