摘要：

目的 观察枕大神经减压联合选择性颞浅动脉结扎术治疗药物难治性偏头痛的临床疗效。方法 纳入2018年1月至2019年6月施行枕大神经减压联合选择性颞浅动脉结扎术治疗的19例药物难治性偏头痛患者，采用视觉模拟评分（VAS）和偏头痛残疾程度评价问卷（MIDAS）评价手术效果。结果 平均住院时间（3.00±0.67）d，术后恶心、呕吐、畏声、畏光症状消失，手术满意率100%。术后VAS评分达优者17例、良2例，MIDAS分级均为Ⅰ级，手术前后疼痛程度比较差异具有统计学意义（VAS评分：Z=-5.559，P=0.000；MIDAS分级：Z=-5.808，P=0.000）。随访期间无手术切口感染等相关并发症发生。结论 枕大神经减压联合选择性颞浅动脉结扎术治疗药物难治性偏头痛的临床疗效良好，创伤小、安全可靠。

关键词: 偏头痛, 减压术, 外科, 结扎术, 脊神经, 颞动脉

Abstract:

Objective To investigate the clinical effect of greater occipital nerve decompression combined with selective superficial temporal artery ligation for treatment of medically intractable migraine. Methods and Results Clinical data of 19 patients with medically intractable migraine treated by greater occipital nerve decompression combined with selective superficial temporal artery ligation were retrospectively analyzed from January 2018 to June 2019. Visual Analog Scale (VAS) and Migraine Disability Assessment (MIDAS) were used to evaluated efficacy of the operation. The mean duration in hospital was (3.00 ±0.67) d. Nineteen patients with preoperative syndrome such as vomiting, nausea, photophobia and phonophobia disappeared after surgery. The degree of pain was evaluated on the first day after operation, 17 patients with 0 score, two patients with one to three score according to postoperative VAS. Nineteen patients with Ⅰ level according to postoperative MIDAS. There was a significant difference of pain degree before and after the operation (VAS:Z=-5.559, P=0.000; MIDAS:Z=-5.808, P=0.000). None occurred surgical incision infection. Conclusions Greater occipital nerve decompression combined with selective superficial temporal artery ligation presents an excellent clinical effect in patients with medically intractable migraine, and also, it is a safe and micro-invasion procedure.

Key words: Migraine, Decompression, surgical, Ligation, Spinal nerves, Temporal arteries