目的: 比较球囊压迫术（percutaneous balloon compression,PBC）与射频热凝术（radiofrequency thermocoagulation,RFT）对原发性三叉神经痛治疗效果。方法: 选取2021年1月―2022年12月我院疼痛科收治原发性三叉神经痛患者（100例）为研究对象,按照随机数字表法将患者随机分为两组,RFT组（50例）和PBC组（50例）,比较两组患者临床疗效[巴罗神经学研究（BNI）疼痛强度量表]、疼痛情况[数字疼痛评分法（NRS）]、血清神经递质[血清P物质（SP）、β-内啡肽（β-EP）及5-羟色胺（5-HT）]含量、睡眠情况及恢复质量[匹兹堡睡眠质量指数（PSQI）及术后患者恢复质量量表（QoR-40）],并记录术后3 月内并发症发生情况。结果: 术后3 d及术后3月,两组患者总缓解率均无显著差异。术前、术后3 d、术后1月及术后3月,两组患者NRS评分无显著差异;术后3 d,两组患者SP均低于术前,且PBC组明显低于RFT,两组患者β-EP及5-HT均高于术前,且PBC组明显高于RF。术后3 d,两组患者PSQL评分均低于术前,且PBC组患者明显低于RFT组,两组患者QoR-40评分无明显差异。PBC组患者感觉减退/面部麻木及咬肌无力发生率高于RFT组,角膜不适发生率低于RFT组。结论: PBC和RFT对原发性三叉神经痛患者均表现良好的临床疗效,但PBC调控神经递质的效果更好,患者术后血流动力学更稳定,且改善患者睡眠质量。
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.
关键词
原发性三叉神经痛 /
射频热凝术 /
球囊压迫术 /
神经递质 /
并发症
Key words
primary trigeminal neuralgia /
radiofrequency thermocoagulation /
percutaneous balloon compression /
neurotransmitters /
complications
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基金
航天医科科研基金资助青年创新项目“探究HIV/AIDS CD4+T淋巴细胞基线及基线病毒载量与长期高效抗转录病毒治疗免疫重建效果相关性”（2021YK12）
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