CT 引导下射频复合阿霉素介入治疗三叉神经痛的临床观察

摘要

Objective To investigate the therapeutic effects and safety of CT-guided radiofrequency thermocoagulation and doxorubicin on trigeminal neuralgia .Methods Sixty patients with trigeminal neuralgia were randomly divided into group A and group B, with 30 patients in each group .The patients in both groups were punctured percutaneously in semilunar ganglion according to CT scanning .The patients in group A were treated by doxorubicin ,however ,the patients in group B were treated by radiofrequency thermocoagulation +doxorubicin .The starting time of therapeutic effects , curative effect score , visual analogue scale (VAS), sleep quality score before treatment and at 1 week ,1 month, 2 months, 4 months and 8 months after treatment were observed and compared between two groups , moreover , the adverse reactions after treatment were observed in both groups .Results The starting time of therapeutic effects in group B was significantly shorter than that in group A .The excellent rates of therapeutic effects at 1week, 2 months, 4 months and 8 months after treatment in group B were significantly higher than those in group A .After treatment the VAS scores in group B in the five time points were significantly lower than those in group A ,however,the sleep quality scores in group B at 2 months,4 months and 8 months after treatment were significantly higher than those in group A ( P <0.05).The incidence of numbness in therapy area of group B was significantly higher than that in group A ( P <0.05).Moreover there were no significant differences in the other adverse reactions between two groups ( P >0.05 ).Conclusion CT-guided radiofrequency thermocoagulation combined with doxorubicin has the advantages of fast efficiency and long -term curative effects in treatment of trigeminal neuralgia .%目的：研究CT引导下阿霉素复合热凝射频对三叉神经痛的临床疗效及安全性。方法三叉神经痛患者60例，随机分为A组和B组，每组30例。在CT引导下，所有患者行半月神经节穿刺，A组患者给予阿霉素治疗，B组给予热凝射频＋阿霉素治疗。比较2组患者起效时间，治疗前、治疗后1周、1个月、2个月、4个月和8个月的疗效评分、视觉模拟评分（ VAS）和睡眠评分，同时观察患者术后不良反应。结果 B组起效时间明显短于A组（ P ＜0．05），治疗后1周、2个月、4个月和8个月的优良率明显高于A组（ P ＜0．05）。 B组治疗后1周、2个月、4个月和8个月VAS评分明显低于A组，治疗后2个月、4个月和8个月的睡眠评分明显高于A组（ P ＜0．05）。 B组麻木发生率高于A组（ P ＜0．05），其他不良反应相比差异无统计学意义（ P ＞0．05）。结论 CT引导下热凝射频复合阿霉素治疗三叉神经具有起效快，疗效长的优点，值得临床推广。