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目的:观察局部药物封闭治疗原发性三叉神经痛的临床疗效。方法:原发性三叉神经痛患者135例,男65例;女60例,年龄35-68岁,平均56岁;病程2个月至12年。病变部位为三叉神经第1支2例,三叉神经第2支18例,三叉神经第3支105例,三叉神经第2支、第3支同时发病10例。治疗方法是,疼痛区的神经干采用维生素B1注射液100mg加维生素B12注射液500μmg加2%利多卡因2.0ml左右作疼痛神经干封闭。三叉神经第1支发病,采用眶上孔封闭;三叉神经第2支发病,采用眶下孔及上颌结节封闭;三叉神经第3支发病,采用下颌孔及颏孔区封闭;每3日注射1次,10次为1疗程,治疗期间服卡马西平0.2g,3次/d。结果:原发性三叉神经痛135例经过1疗程治疗,临床治愈69例,好转46例,无效20例,总有效率85.2%。无效20例中8例经神经外科手术后治愈。治疗过程未发生不良反应。结论:局部药物维生素B1和B12封闭治疗原发性三叉神经痛疗效良好,操作比较简单,且无副作用。
Objective: To observe the clinical efficacy of local drug blocking treatment of primary trigeminal neuralgia. Methods: 135 patients with primary trigeminal neuralgia, 65 males; 60 females, aged 35-68 years, mean 56 years; duration of 2 months to 12 years. Lesions of the first branch of the trigeminal nerve in 2 cases, 18 cases of the second trigeminal nerve, 105 cases of the third trigeminal nerve, the second trigeminal nerve, the first three cases of 10 cases. Treatment is that the pain area of nerve trunk with vitamin B1 injection of vitamin B12 injection of 500μmg plus 2% lidocaine 2.0ml for pain nerve trunk closed. The first branch of the trigeminal disease was occluded by the supraorbital foramen. The second branch of the trigeminal nerve was occluded with the infraorbital foramen and maxillary nodules. The third trigeminal nerve was occluded with the mandibular foramen and the mental foramen. 1 times, 10 times as a course of treatment, during the treatment of carbamazepine 0.2g, 3 times / d. Results: 135 cases of primary trigeminal neuralgia after a course of treatment, clinical cure in 69 cases, 46 cases improved, ineffective in 20 cases, the total efficiency of 85.2%. Invalid 20 cases, 8 cases were cured after neurosurgery. No adverse reactions during treatment. Conclusion: The local drugs vitamin B1 and B12 closed treatment of primary trigeminal neuralgia good effect, the operation is relatively simple, and no side effects.