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目的探索提高微血管减压术治疗三叉神经痛的手术疗效。方法采用显微血管减压术(microvascular decompression,MVD)治疗三叉神经痛患者1150例,其中采取垫隔式MVD258例,围套式MVD共892例。比较两种方法术后的并发症、治愈率和复发率。结果比较两种MVD方法,发现三叉神经痛治愈率、责任血管与三叉神经的关系类型没有差异,围套式MVD术后口唇疱疹、三叉神经损伤的发生率明显高于垫隔式;垫隔式MVD的复发率明显高于围套式,而复发时间明显短于围套式减压方法。结论围套式MVD强调把整个“敏感区”包绕并对减压材料进行固定,更有利于提高治愈率、降低复发率。显微操作精细、技术熟练是MVD术中减少并发症的重要因素。
Objective To explore the surgical treatment of trigeminal neuralgia for improving microvascular decompression. Methods 1150 patients with trigeminal neuralgia were treated with microvascular decompression (MVD). Among them, 848 cases were treated with spacer MVD and 892 cases with circumscribed MVD. Complications, cure rates and recurrence rates were compared between the two methods. Results There was no difference in the relationship between trigeminal neuralgia and trigeminal neuralgia in the cure rate of trigeminal neuralgia. The incidence of oral herpes labialis and trigeminal nerve injury was significantly higher than that of the MVD, MVD recurrence rate was significantly higher than the circumcision, and the recurrence time was significantly shorter than the cuff decompression method. Conclusion Enclosed MVD emphasizes the entire “sensitive area ” wrapped around and decompression material fixation, more conducive to improving the cure rate and reduce the recurrence rate. Fine micro-operation, skilled MVD is an important factor in reducing complications.