摘要：

目的 探讨CT 引导下三叉神经节脉冲射频术治疗非典型面痛的有效性和安全性。方法 共37 例非典型面痛患者均于CT 引导下经Hartel前入路卵圆孔穿刺行三叉神经节脉冲射频术，分别于术前和术后1 d、7 d、1 个月、3 个月、6 个月采用视觉模拟评分（VAS）评价疼痛程度并计算完全缓解率、优良率和有效率，记录术后并发症。结果 手术成功率100%。术后随访6 个月，1例失访，36例完成随访。36 例患者手术前后VAS 评分差异有统计学意义（H = 89.784，P = 0.000），术后1 d（Z = -5.255，P = 0.000）、7 d（Z = -5.258，P = 0.000）、1 个月（Z = -5.255，P = 0.000）、3 个月（Z = -5.249，P = 0.000）和6 个月（Z = -5.121，P = 0.000）VAS 评分均低于术前。术后1 d、7 d、1 个月、3 个月和6 个月完全缓解率分别为25%（9/36）、22.22%（8/36）、19.44%（7/36）、19.44%（7/36）和16.67%（6/36），优良率分别为80.56%（29/36）、77.78%（28/36）、72.22%（26/36）、69.44%（25/36）和63.89%（23/36），有效率分别为88.89%（32/36）、88.89%（32/36）、86.11%（31/36）、86.11%（31/36）和80.56%（29/36）。术后2 例（5.56%）出现短暂性恶心、呕吐，3 例（8.33%）出现面部肿胀，2 例（5.56%）出现轻度面部麻木，均逐渐自行缓解。结论 CT 引导下经卵圆孔穿刺行三叉神经节脉冲射频术治疗非典型面痛疗效确切，安全性较高。

关键词: 面部疼痛, 三叉神经节, 脉冲射频（非MeSH 词）, 体层摄影术, X 线计算机

Abstract:

Objective  To evaluate the efficacy and safety of pulse radiofrequency of trigeminal ganglion via foramen ovale for treatment of atypical facial pain (AFP) under the guidance of CT.  Methods  A total of 37 patients with AFP underwent pulse radiofrequency of trigeminal ganglion via foramen ovale through Hartel anterior approach under the guidance of CT. Visual Analogue Scale (VAS) was used to evaluate the degree of pain before and 1 d, 7 d, 1 month, 3 months, 6 months after treatment. The rates of complete relief, excellent effect and good effect were calculated, and postoperative complications were recorded.  Results  The success rate of operation was 100%. During 6-month follow-up, one case was lost, 36 cases finished follow-up. There was significant difference in VAS scores before and after operation (H = 89.784, P = 0.000). Compared with before treatment, VAS scores at 1 d (Z = -5.255, P = 0.000), 7 d (Z = -5.258, P = 0.000), 1 month (Z = -5.255, P = 0.000), 3 months (Z = -5.249, P = 0.000) and 6 months (Z = -5.121, P = 0.000) after treatment were significantly decreased. The rate of complete pain relief at 1 d, 7 d, 1 month, 3 months and 6 months after treatment was 25% (9/36), 22.22% (8/36), 19.44% (7/36), 19.44% (7/36) and 16.67% (6/36); the rate of excellent effect at 1 d, 7 d, 1 month, 3 months and 6 months after treatment was 80.56% (29/36), 77.78% (28/36), 72.22% (26/36), 69.44% (25/36) and 63.89% (23/36); the rate of good effect at 1 d, 7 d, 1 month, 3 months and 6 months after treatment was 88.89% (32/36), 88.89% (32/36), 86.11% (31/36), 86.11% (31/36) and 80.56% (29/36), respectively. After treatment, there were 2 cases (5.56%) of transient nausea and vomiting, 3 cases (8.33%) of facial swelling and 2 cases (5.56% ) of mild facial numbness. Those symptoms were relieved spontaneously.  Conclusions  Pulse radiofrequency of trigeminal ganglion via foramen ovale for treatment of AFP under the guidance of CT is effective and safe.

Key words: Facial pain, Trigeminal ganglion, Pulse radiofrequency (not in MeSH), Tomography, X-ray computed