伽玛刀对老年人群原发性三叉神经痛的疗效及预后分析

摘要/Abstract

摘要： 目的分析伽玛刀（Gamma Knife Stereotactic,GKS）对原发性三叉神经痛（Primary Trigeminal Neuralgia,PTN）老年和中年患者在疗效、复发率、并发症等方面的差异性。方法采集2017年1月—2020年4月于郑州大学第五附属医院伽玛刀中心进行GKS治疗的78例PTN患者的病历资料进行回顾性分析,根据年龄分为老年组（≥70岁）（45例）与中年组（<60岁）（33例）。通过电话及门诊随访方式收集术后疗效、复发情况及相关并发症资料并进行差异性分析。结果老年组术后疼痛缓解有效率高于中年组（P<0.05）;老年组疼痛复发率低于中年组（P<0.05）;在亚组分型比较中,老年-TN1组复发率明显低于中年-TN1组（P<0.05）;老年组面部麻木出现时间晚于中年组（P<0.05）。结论相较于中年人群,伽玛刀对于PTN老年患者能够提供更好的疼痛缓解效果,并且复发风险较低。对于手术风险较高的PTN老年人群,伽玛刀是一种较好的替代治疗方式。

关键词: 伽玛刀, 原发性三叉神经痛, 老年人群, 临床疗效, 并发症, 复发率

Abstract: Objective The differences in curative effect, recurrence rate and complications of gamma knife(GKS) in elderly patients with primary trigeminal neuralgia (PTN) were retrospectively analyzed. Methods The medical records of PTN patients who were treated with GKS in the Gamma knife Center of the Fifth affiliated Hospital of Zhengzhou University from January 2017 to April 2020 were collected and divided into elderly group (≥70 years old) and middle-aged group (<60 years old). The data of postoperative curative effect, recurrence and related complications were collected by telephone and outpatient follow-up and the differences were analyzed. Results The effective rate of postoperative pain relief in the elderly group was higher than that in the middle-aged group (P<0.05). The recurrence rate in the elderly group was lower than that in the middle-aged group (P<0.05). The recurrence rate in the middle-aged-TN1 group was significantly lower than that in the middle-aged-TN1 group. The occurrence of facial numbness in the elderly group was later than that in the middle-aged group (P<0.05). Conclusion Compared with middle-aged people, gamma knife can provide better pain relief for elderly patients with PTN, and the risk of recurrence is lower. Gamma knife is a good alternative therapy for elderly PTN patients with high surgical risk.

Key words: gamma knife, primary trigeminal neuralgia, elderly patients, clinical curative effect, complication, relapse rate

中图分类号:

R454.9

陈冠岐, 郭永坤, 刘婉清, 毛建超, 张庆祝, 单峤. 伽玛刀对老年人群原发性三叉神经痛的疗效及预后分析[J]. 中华养生保健, 2023, 41(22): 44-48.

CHEN Guan-qi, GUO Yong-kun, LIU Wan-qing, MAO Jian-chao, ZHANG Qing-zhu, SHAN Qiao. Analysis of Efficacy and Prognosis of Gamma Knife in the Treatment of Primary Trigeminal Neuralgia in the Elderly[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(22): 44-48.

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