›› 2017, Vol. 37 ›› Issue (10): 905-909.

• 临床研究 • 上一篇    下一篇

X线下2种穿刺方法射频热凝治疗上颌神经痛的疗效分析

陈冬雷1,2,王翔2,何玉泉3,李小龙3   

  1. 1. 南京医科大学附属口腔医院
    2. 南通市第一人民医院
    3. 南通大学第二附属医院影像科
  • 收稿日期:2016-05-03 修回日期:2016-06-22 出版日期:2017-10-28 发布日期:2017-10-13
  • 通讯作者: 王翔 E-mail:71505875@qq.com

Curative effect analysis of the radiofrequency thermocoagulation for treating maxillary nerve neuralgia by two percutaneous puncture methods under X-ray

  • Received:2016-05-03 Revised:2016-06-22 Online:2017-10-28 Published:2017-10-13

摘要: 【摘要】:目的:X线下经皮穿刺卵圆孔和圆孔射频治疗上颌神经痛临床疗效对比研究。方法:对2008-2015年收治住院的69例单纯上颌神经痛患者分为2组。A组:33例,穿刺卵圆孔,患者采用Hartel前入路法,根据射频针尖至耳-床线的垂直距离确定入颅深度后,行射频热凝。B组:36例,穿刺圆孔,采用弯针穿刺进入翼腭窝,局部注射2%利多卡因1ml,X线定位圆孔穿刺方向,再穿入圆孔,X线下定位确定进入圆孔后行射频治疗。结果:所有患者均顺利完成手术,穿刺针均准确位于圆孔内和卵圆孔内,治疗后疼痛即刻缓解,无严重并发症发生,眶下区及上腭均有感觉迟钝。所有患者随访6个月~2 年,两组3天有效率、术后复发率差异比较无统计学意义( P >0.05) 。两组在非患支神经损伤的发生率差异显著( P <0.05) 。A组:手术时间平均48.79分钟;B组:平均50.32分钟。术中疼痛评分:A组:平均7.48分;B组:平均2.92分。结论:经翼腭窝穿刺圆孔治疗上颌神经疼痛具有一定的优势,值得推广。

关键词: 【关键词】:三叉神经痛, 圆孔, 卵圆孔, 射频热凝

Abstract: Abstract Objective:To observe the clinical effects of percutaneous puncturing of foramen rotundum(FR) and foramen oval(FO) for radiofrequency thermocoagulation to treat primary maxillary nerve neuralgia under X-ray. Methods:69 cases of simple maxillary neuralgia patients were divided into two groups, which were hospitalized in our hospital from 2008 to 2015. Group A: 33 cases were punctured into FO by Hartel, measure the cranial - the vertical distance line between the needlepoint and ear-clinoidal line, then radiofrequency thermocoagulation. Group B: 36 cases were punctured into FR , at first puncture into pterygopalatine fossa (PPF)with curved needle, inject 2% lidocaine 1ml, under X-ray locate the direction, then piercing into FR, under X-ray into the FR was determined before radiofrequency thermocoagulation.Results:All patients were successfully completed surgery, the needles are accurate in the FR and FO, pain was relief after treatment immediatly, and no serious complications were occurred, infraorbital region and palate are insensitive. All patients were followed up for 6 months to 2 years, Two groups of 3 days of efficiency, postoperative recurrence rate difference is not significant (P > 0.05).Two groups in the risk of a significant difference was found in the incidence of no trouble nerve injury (P < 0.05). Group A:Operation average time are 48.79 minutes; group B: Operation average time are 50.32 minutes.Intraoperative pain score: group A: the average are 7.48 points;Group B: the average are 2.92 points.Conclusion:It is worth promoting for the treatment of maxillary nerve neuralgia with piercing FR pass by PPF because of certain advantages.

Key words: Key words: Maxillary nerve neuralgia, Foramen rotundum, Foramen oval, Radiofrequency thermocoagulation

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