|
|
The efficacy of balloon compression and radiofrequency thermocoagulation in the treatment of primary trigeminal neuralgia |
ZHU Jian, CHEN Silou, AI Liang, WANG Xiaofeng |
Hunan Aerospace Hospital, Changsha 410205, China |
|
|
Abstract Objective To investigate the efficacy of percutaneous balloon compression (PBC) and radiofrequency thermocoagulation (RFT) in the treatment of primary trigeminal neuralgia and its effect on serum neurotransmitters. Methods 100 patients with primary trigeminal neuralgia admitted to the pain department of our hospital from January 2021 to December 2022 were selected as the research objects. According to the random number table method, the patients were randomly divided into two groups.50 patients treated with RFT were in the RFT group, and 50 patients treated with PBC were in the PBC group. The clinical efficacy [barrow neurological institute (BNI) pain intensity scale], pain (numeric rating scales, NRS), serum neurotransmitters [serum substance P (SP), β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) ], sleep status and recovery quality [pittsburgh sleep quality index (PSQI) and postoperative quality of recovery-40 que were compared between the two groups. Results There was no significant difference in the total remission rate between the two groups at 3 days and 3 months after operation. There was no significant difference in NRS scores between the two groups before operation, 3 days after operation, 1 month after operation and 3 months after operation. At 3 days after operation, SP in both groups decreased, and that in the observation group was lower. β-EP and 5-HT in both groups increased, and those in the observation group were higher. Three days after operation, the PSQL scores of the two groups decreased, and that of the observation group was lower than that of the control group. The QoR-40 scores of the two groups did not increase, and there was no difference between the two groups. The incidence of hypoesthesia/facial numbness and masseter weakness in the observation group was higher than that in the control group, and the incidence of corneal discomfort was lower than that in the control group. Conclusion The clinical efficacy of PBC and RFT in patients with primary trigeminal neuralgia is similar.
|
Received: 18 October 2023
|
|
|
|
|
[1] BENDTSEN L, ZAKRZEWSKA JM, HEINSKOU TB, et al.Advances in diagnosis, classification, pathophysiology, and management of trigeminal neuralgia[J]. Lancet Neurol, 2020, 19(9): 784-796. [2] RUSCHEWEYH R, LUTZ J, MEHRKENS JH.Trigeminusneuralgie. Moderne Diagnostik und Therapie[J]. Schmerz, 2020, 34(6): 486-494. [3] MIZOBUCHI Y, NAGAHIRO S, KONDO A, et al.Microvascular Decompression for Trigeminal Neuralgia: A Prospective, Multicenter Study[J]. Neurosurgery, 2021, 89(4): 557-564. [4] WANG Z, SU X, YU Y, et al.A review of literature and meta-analysis of one-puncture success rate in radiofrequency thermocoagulation with different guidance techniques for trigeminal neuralgia[J]. Eur J Med Res, 2022, 27(1): 141. [5] JAIN A, IBRAHIM B, ALI A, et al.Percutaneous balloon compression technique using intraoperative contrasted DynaCT for the treatment of refractory trigeminal neuralgia: initial experience[J]. Neurosurg Rev, 2022, 45(2): 1393-1399. [6] 中华医学会神经外科学分会功能神经外科学组, 中国医师协会神经外科医师, 分会功能神经外科专家委员会, 等. 三叉神经痛诊疗中国专家共识[J]. 中华外科杂志, 2015, 53(9): 657-664. [7] LOCHHEAD RA, ABLA AA, MITHA AP, et al.A history of the Barrow Neurological Institute[J]. World Neurosurg, 2010, 74(1): 71-80. [8] 严广斌. NRS 疼痛数字评价量表 numerical rating scale[J]. 中华关节外科杂志(电子版), 2014, 8(3): 92. [9] 路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度、效度及反应度研究[C]. 中国中西医结合学会循证医学方法在中西医结合皮肤病临床研究中的应用研讨会论文集, 重庆: 中国中西医结合学会, 2012: 102-103. [10] 张莹, 徐亮, 尹荣真, 等. 40项恢复质量评分量表评估老年胃肠道肿瘤切除术患者早期恢复质量的研究[J]. 中国医师进修杂志, 2019, 42(1): 2-5. [11] 侯锐, 翟新利, 方剑乔, 等. 原发性三叉神经痛中西医非手术诊疗方法的专家共识[J]. 实用口腔医学杂志, 2022, 38(2): 149-161. [12] 何睿林, 冉娅, 胡鑫, 等. 原发性三叉神经痛术前MRI特征与疼痛程度及射频热凝术预后的关系[J]. 中国疼痛医学杂志, 2021, 27(5): 342-347. [13] TANG YZ, YANG LQ, YUE JN, et al.The optimal radiofrequency temperature in radiofrequency thermocoagulation for idiopathic trigeminal neuralgia: A cohort study[J]. Medicine (Baltimore), 2016, 95(28): e4103. [14] 丁滢滢, 纪荣明, 胡旭, 等. Meckel囊在经皮穿刺球囊压迫术治疗三叉神经痛中的应用解剖[J]. 解剖学杂志, 2022, 45(5): 397-401. [15] 曾诗意, 王文波, 戚圣金, 等. 导航辅助经皮穿刺三叉神经半月节球囊压迫术15例分析[J]. 中国实验诊断学, 2019, 23(4): 662-664. [16] 朱洪宽, 张顺吉, 陈永伦. DSA引导射频热凝联合血府逐瘀方治疗原发性三叉神经痛疗效及对血浆β-内啡肽及P物质的影响[J]. 现代中西医结合杂志, 2017, 26(27): 3020-3022. [17] 南忠庆, 张明晓, 刘建龙, 等. 背根神经节脉冲射频刺激联合普瑞巴林治疗对三叉神经痛的疗效及患者血清CGRP、5-HT水平的影响[J]. 重庆医科大学学报, 2020, 45(8): 1184-1187. [18] RATH GP, SHARMA VB, DUBE SK.Persistent Premature Atrial Contraction as the Sole Presentation of Trigeminocardiac Reflex during Radiofrequency Thermocoagulation[J]. J Neurosurg Anesthesiol, 2017, 29(2): 187-188. [19] 赵浩然, 姚鹏. 不同温度射频热凝术治疗三叉神经痛的研究进展[J]. 中国疼痛医学杂志, 2020, 26(9): 689-693. [20] 孙承龙, 朱强, 杜权, 等. 球囊压迫术治疗三叉神经痛时标准梨形球囊与非梨形球囊的疗效比较[J]. 浙江医学, 2022, 44(3): 246-249. [21] 张蕾, 罗伟, 尹涛, 等. 经皮穿刺微球囊压迫术对三叉神经痛患者治疗效果、炎症、氧化应激及并发症的影响[J]. 临床误诊误治, 2022, 35(4): 94-98. |
|
|
|