| 孔显微血管减压术治疗颅神经血管压迫综合征临床研究 |
| Alternative Title | A Clinical Study of Microvascular Decompression with Keyhole for Cranial Neurovascular Compression Syndrome
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| 兰正波 |
| Thesis Advisor | 张新定
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| 2013-05-24
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 三叉神经痛
面肌痉挛
舌咽神经痛
显微血管减压术
颅神经血管压迫综合征
锁孔
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| Abstract | 目的 通过对颅神经血管压迫综合征（NVCS）患者的临床资料、术中发现及神经影像学所见进行分析，研究影响锁孔显微血管减压术（MVD）治疗NVCS预后的相关因素，以期进一步提高手术疗效。
方法 收集兰大二院2011年3月至2013年2月期间，行MVD术的NVCS患者的临床资料，评价手术疗效、并发症以及患者的满意度，分析影响手术疗效的因素。
结果 本组共88例，所有病例均采用锁孔下乙状窦后入路顺利完成手术。术中未发现责任血管有4例（4.55%），有责任血管84例（95.45%），表现为压迫的75例，接触的3例，贯穿的6例。随访时间平均10.72个月。两年间手术并发症的比较，第一年（9例）明显多于第二年（2例）（χ2=8.161，P=0.004）。1a型TN与1b型TN相比血管压迫更明确和疗效更好，患者对手术的满意度有差异（χ2=8.360，P=0.013）。影像发现血管压迫组与未发现组相比术中发现和手术疗效均相似，患者的满意度无差异（χ2=0.731，P=0.694）。
结论 NVCS发病主要与责任血管压迫有关，MVD术疗效优秀，并发症在可以接受范围内。对于TN，1a型通常责任血管更明确，效果更佳。手术疗效及并发症与术者操作熟练程度相关。术前影像学检查不是判定有无责任血管和疗效的手段。
关键词：三叉神经痛，面肌痉挛，舌咽神经痛，显微血管减压术，颅神经血管压迫综合征，锁孔 |
| Other Abstract | Objective By analysis the cranial neurovascular compression syndrome (NVCS) patient's clinical data and intraoperative findings and neuroimaging seen, to study the impact of prognostic factors for NVCS who treated with keyhole microvascular decompression, for improving surgical outcome and reducing complications.
Methods A total of 88 cases of NVCS patients who have did microvascular decompression (MVD) clinical date were collected during the period of March 2011 to February 2013 at Department of Neurosurgery, the Second Hospital of Lanzhou University. To recorded the compressing vessels and compression type, evaluation of surgical treatment/complications and patient satisfaction，Analysis the factors which affect the efficacy of surgery.
Results The group of 88 cases, all treated with keyhole microvascular decompression. The intraoperative findings no compressing vessel in 4 cases(4.55%), have the compressing vessel in 84 cases (95.45%), the types of the vessels, the 75 cases conspicuous compression, the 3 cases contact, the 6 cases throughout the nerve root. Follow-up time is an average of 10.72 months. Serious complications: Cerebral hemorrhage in 3 cases (4.55%), including one patient died ( 1.14% ), the other two cases surgery to remove the hematoma. Comparison of complications in the two-year period, the first year of patients (9 cases) significantly more than the second year of patients (2 cases) (χ2 = 8.161, P = 0.004).The type 1a TN vascular compression compared with the type 1b TN clearer and better efficacy, satisfaction of the two groups of patients for surgery are different ( χ2 = 8.360 , P = 0.013 ). The Preoperative images find NVC group compared to not find NVC group intraoperative findings and surgical treatment were similar, patient satisfaction were no differences (χ2 = 0.731, P = 0.694).
Conclusion The NVCS incidence of major Related to the NVC, MVD curative effect is excellent, complications in the acceptable range. For type 1a TN, the usual NVC clearer and the curative effect better. Surgical curative effect and complications related with the surgeon operating proficiency. Preoperative imaging is not means to determine whether there have NVC vessels and the surgical curative effect.
Key words: trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, microvascular decompression, cranial neurovascular compression syndrome，keyhole |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223149
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
兰正波. 孔显微血管减压术治疗颅神经血管压迫综合征临床研究[D]. 兰州. 兰州大学,2013.
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