2022 年第 2 期 第 17 卷

低温等离子消融术与射频热凝术治疗三叉神经痛的对照研究

A control study on low-temperature plasma ablation and radiofrequency thermocoagulation in the treatment of trigeminal neuralgia

作者：卞晶晶郭玉娜唐元章武百山倪家骧

英文作者：Bian Jingjing Guo Yuna Tang Yuanzhang Wu Baishan Ni Jiaxiang

单位：首都医科大学宣武医院疼痛科，北京100053

英文单位：Department of Pain Management Xuanwu Hospital Capital Medical University Beijing 100053 China

关键词：三叉神经痛；低温等离子消融术；射频热凝术；疼痛；麻木 

英文关键词：Trigeminalneuralgia;Low-temperatureplasmaablation;Radiofrequencythermocoagulation;Pain;Numbness

• 摘要：

• 目的  比较低温等离子消融术和射频热凝术治疗三叉神经痛的有效性和安全性。方法  收集2020年5—12月首都医科大学宣武医院疼痛科收治的行三叉神经外周支毁损治疗三叉神经痛患者的临床资料行回顾性分析。其中52例接受超声引导下三叉神经外周支低温等离子消融术治疗(A组)，38例接受超声引导下射频热凝术治疗(B组)。对比2组术前及术后3、6个月疼痛数字评分法（NRS）评分、面部麻木评分、面部浅感觉分级及并发症发生情况。结果  2组术后3、6个月NRS评分均明显低于术前（均P＜0.05），但是2组间术前及术后各时点NRS评分差异均无统计学意义（均P>0.05）。A组术后3、6个月面部麻木评分及术后6个月面部浅感觉中重度感觉障碍发生率明显低于B组［（3.6±2.1）分比（5.2±2.7）分、（2.7±1.6）分比（4.2±2.1）分，32.7%（17/52）比63.2%（24/38）］，差异均有统计学意义（均P<0.05）。2组患者术后均无严重并发症发生。结论  超声引导下三叉神经外周支低温等离子消融术和射频热凝术治疗三叉神经痛均有效，但前者术后面部麻木及中重度面部浅感觉障碍的发生率明显较低。

• Objective To compare the efficacy and safety of low-temperature plasma ablation and radiofrequency thermocoagulation on the treatment of trigeminal neuralgia. Methods The clinical data of patients with trigeminal neuralgia treated by peripheral branch destruction of trigeminal nerve in Department of Pain Management, Xuanwu Hospital, Capital Medical University from May to December 2020 were collected and analyzed retrospectively. Among them, 52 cases were treated with ultrasound-guided low-temperature plasma ablation of peripheral branch destruction of trigeminal nerve(group A), and 38 cases were treated with ultrasound-guided radiofrequency thermocoagulation(group B). The pain numeric rating scale(NRS) score, facial numbness score, shallow facial sensation classification and complications were compared between the two groups before operation and 3 and 6 months after operation. Results The NRS scores of the two groups 3 and 6 months after operation were significantly lower than those before operation(all P<0.05), but there were no significant differences between the two groups at each time point (all P>0.05). The facial numbness score 3 and 6 months after operation and the incidence of mild and severe shallow sensory impairment 6 months after operation in group A were significantly lower than those in group B［（3.6±2.1） vs （5.2±2.7）, （2.7±1.6） vs （4.2±2.1）, 32.7%（17/52） vs 63.2%（24/38）］(all P<0.05). There were no serious complications in both groups after operation. Conclusion Ultrasound guided low-temperature plasma ablation and radiofrequency thermocoagulation are effective in the treatment of trigeminal neuralgia, but the incidences of facial numbness and mild and severe shallow sensory impairment after operation are significantly lower in the former.