伽瑪刀治療三叉神經痛疼痛緩解時間分析_《華西醫學》

作者：

張祝均 , 李楊 ,  李鵬 , 王偉 , 任海波

四川大學華西醫院神經外科（成都，610041）;

關鍵詞：

伽瑪刀三叉神經痛疼痛緩解時間

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目的　分析和總結采用雙靶點伽瑪刀治療三叉神經痛術后疼痛緩解時間規律，為伽瑪刀的臨床治療提供參考。方法　2005年1月－2011年1月，共147例原發性三叉神經痛患者于四川大學華西醫院接受Leksell C型伽瑪刀治療。使用4 mm準直器在三叉神經根制作2個等中心靶點，中心劑量80~90 Gy，控制腦橋照射劑量＜20 Gy。術后定期對患者進行隨訪，對疼痛緩解時間進行統計分析。結果　130例患者獲得隨訪，隨訪時間11～64個月，平均28.7個月。術后疼痛完全緩解95例（73.1%），部分緩解29例（22.3%），無效6例（4.6%）。疼痛緩解時間4 h～12個月，平均3.6周，其中疼痛完全緩解患者的疼痛緩解時間明顯短于部分緩解患者（P＜0.05）。53例（40.8%）患者于術后出現術側輕度面部麻木。結論　患者術后疼痛緩解時間可能是預測伽瑪刀治療效果的重要因素，但疼痛緩解時間個體差異大，應進行長期隨訪觀察。

引用本文： 張祝均,李楊,李鵬,王偉,任海波. 伽瑪刀治療三叉神經痛疼痛緩解時間分析. 華西醫學, 2012, 27(6): 889-891. doi: 復制

1.	Rogers CL, Shetter AG, Fiedler JA, et al. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute[J]. Int J Radiat Oncol Biol Phys, 2000, 47(4): 1013-1019.
2.	Cruccu G, Gronseth G, Alksne J, et al. AAN-EFNS guidelines on trigeminal neuralgia management[J]. Eur J Neurol, 2008, 15(10): 1013-1028.
3.	Kondziolka D, Lunsford LD, Flickinger JC, et al. Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit[J]. J Neurosurg, 1996, 84(6): 940-945.
4.	Brisman R. Gamma knife radiosurgery for primary management for trigeminal neuralgia[J]. J Neurosurg, 2000, 93(Suppl 3): 159-161.
5.	Petit JH, Herman JM, Nagda S, et al. Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes[J]. Int J Radiat Oncol Biol Phys, 2003, 56(4): 1147-1153.
6.	趙洪洋, 童萼塘, 趙沃華. 原發性三叉神經痛的伽瑪刀雙靶點治療[J]. 中華神經外科雜志, 2005, 21(4): 216-219.
7.	Maesawa S, Salame C, Flickinger JC, et al. Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2001, 94(1): 14-20.
8.	Longhi M, Rizzo P, Nicolato A, et al. Gamma knife radiosurgery for trigeminal neuralgia: results and potentially predictive parameters-partⅠ: idiopathic trigeminal neuralgia[J]. Neurosurgery, 2007, 61(6): 1254-1260.
9.	宗建海, 劉華峰, 董玉霞, 等. 伽瑪刀治療原發性三叉神經痛的療效[J]. 中國微創外科雜志, 2010, 16(4): 365-367.
10.	方俊杰, 趙洪洋, 楊衛忠. 伽瑪刀雙靶點治療原發性三叉神經痛的臨床研究[J]. 中國神經精神疾病雜志, 2009, 35(6): 339-341.
11.	Pollock BE, Phuong LK, Gorman DA, et al. Stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2002, 97(2): 347-353.
12.	Tawk RG, Duffy-Fronckowiak M, Scott BE, et al. Stereotactic gamma knife surgery for trigeminal neuralgia: detailed analysis of treatment response[J]. J Neurosurg, 2005, 102(3): 442-449.
13.	Marshall K, Chan MD, McCoy TP, et al. Predictive variables for the successful treatment of trigeminal neuralgia with gamma knife radiosurgery[J]. Neurosurgery, 2012, 70(3): 566-573.
14.	Yen CP, Schlesinger D, Sheehan JP, et al. Gamma Knife? radiosurgery for trigeminal neuralgia[J]. Expert Rev Med Devices, 2011, 8(6): 709-721.
15.	Park SH, Hwang SK. Outcomes of gamma knife radiosurgery for trigeminal neuralgia after a minimum 3-year follow-up[J]. J Clin Neurosci, 2011, 18(5): 645-648.

1. 　Rogers CL, Shetter AG, Fiedler JA, et al. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute[J]. Int J Radiat Oncol Biol Phys, 2000, 47(4): 1013-1019.
2. 　Cruccu G, Gronseth G, Alksne J, et al. AAN-EFNS guidelines on trigeminal neuralgia management[J]. Eur J Neurol, 2008, 15(10): 1013-1028.
3. 　Kondziolka D, Lunsford LD, Flickinger JC, et al. Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit[J]. J Neurosurg, 1996, 84(6): 940-945.
4. 　Brisman R. Gamma knife radiosurgery for primary management for trigeminal neuralgia[J]. J Neurosurg, 2000, 93(Suppl 3): 159-161.
5. 　Petit JH, Herman JM, Nagda S, et al. Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes[J]. Int J Radiat Oncol Biol Phys, 2003, 56(4): 1147-1153.
6. 　趙洪洋, 童萼塘, 趙沃華. 原發性三叉神經痛的伽瑪刀雙靶點治療[J]. 中華神經外科雜志, 2005, 21(4): 216-219.
7. 　Maesawa S, Salame C, Flickinger JC, et al. Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2001, 94(1): 14-20.
8. 　Longhi M, Rizzo P, Nicolato A, et al. Gamma knife radiosurgery for trigeminal neuralgia: results and potentially predictive parameters-partⅠ: idiopathic trigeminal neuralgia[J]. Neurosurgery, 2007, 61(6): 1254-1260.
9. 　宗建海, 劉華峰, 董玉霞, 等. 伽瑪刀治療原發性三叉神經痛的療效[J]. 中國微創外科雜志, 2010, 16(4): 365-367.
10. 　方俊杰, 趙洪洋, 楊衛忠. 伽瑪刀雙靶點治療原發性三叉神經痛的臨床研究[J]. 中國神經精神疾病雜志, 2009, 35(6): 339-341.
11. 　Pollock BE, Phuong LK, Gorman DA, et al. Stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2002, 97(2): 347-353.
12. 　Tawk RG, Duffy-Fronckowiak M, Scott BE, et al. Stereotactic gamma knife surgery for trigeminal neuralgia: detailed analysis of treatment response[J]. J Neurosurg, 2005, 102(3): 442-449.
13. 　Marshall K, Chan MD, McCoy TP, et al. Predictive variables for the successful treatment of trigeminal neuralgia with gamma knife radiosurgery[J]. Neurosurgery, 2012, 70(3): 566-573.
14. 　Yen CP, Schlesinger D, Sheehan JP, et al. Gamma Knife? radiosurgery for trigeminal neuralgia[J]. Expert Rev Med Devices, 2011, 8(6): 709-721.
15. 　Park SH, Hwang SK. Outcomes of gamma knife radiosurgery for trigeminal neuralgia after a minimum 3-year follow-up[J]. J Clin Neurosci, 2011, 18(5): 645-648.

《華西醫學》

伽瑪刀治療三叉神經痛疼痛緩解時間分析

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《華西醫學》

伽瑪刀治療三叉神經痛疼痛緩解時間分析

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