孙海燕,武百山,何明伟,杨立强,倪家骧.CT引导下射频热凝毁损治疗顽固性舌咽神经痛的观察[J].中国康复医学杂志,2009,24(7):616~618 |
CT引导下射频热凝毁损治疗顽固性舌咽神经痛的观察 点此下载全文 |
孙海燕 武百山 何明伟 杨立强 倪家骧 |
首都医科大学宣武医院疼痛诊疗中心,北京,100053 |
基金项目:北京市科委重大课题(课题编号Y0204003040631) |
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目的:观察CT引导下颈外侧入路射频热凝毁损对于顽固性舌咽神经痛的治疗效果和并发症。方法:32例顽固性舌咽神经痛患者,在CT引导下行颈外侧入路经皮穿刺,行射频热凝舌咽神经毁损治疗。观察术前、术后1周及出院后随访时的疼痛情况、情绪评分以及并发症的发生情况。结果:26例患者术后疼痛消失,4例患者术后疼痛减轻。其余2例合并三叉神经痛患者术后行半月神经节射频毁损术,术后疼痛消失。随访期间28例疼痛消失无复发,2例在出院1个月内疼痛消失,1例仍部分缓解,1例喉癌继发性舌咽神经痛在术后2个月复发。所有患者视觉模拟评分(VAS)疼痛与情绪评分明显降低,无严重并发症发生。结论:CT引导下颈外侧入路舌咽神经射频热凝毁损术具有安全疗效可靠和定位准确的特点,可有效降低严重并发症的发生率。 |
关键词:舌咽神经痛 CT引导穿刺 射频 毁损性阻滞 |
CT-guided radiofrequency neurolysis for the treatment of intractable glossopharyngeal neuralgia Download Fulltext |
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Pain Medical Center,Xuanwu Hospital,Capital University of Medical Sciences,Beijing, 100053 |
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Abstract: |
Objective:To investigate the effects and complications of CT-guided cervical approach radiofrequency neurolytic therapy on intractable glossopharyngeal neuralgia(GPN). Method:Thirty-two patients with intractable glossopharyngeal neuralgia were treated by CT-guided percutaneous puncture from cervical approach and neurolytic glossopharyngeal block with radiofrequency. The information regarding pain severity, mood assessment, functional outcomes and complications of patients before operation, one week after operation and sometime at the follow-up were collected and assessed. Result:After operation, pain disappeared in 26 cases and partly relieved in 4 cases; 2 cases with coexistent trigeminal neuralgia acquired pain disappearance after receiving trigeminal ganglion radiofrequency neurolysis. During the following-up period, pain disappeared in 28 cases and relieved completely 1 month after discharging from hospital in 2 cases. Pain relieved partly in 1 case. Pain recurred in 1 case 2 months after operation, whose GPN was secondary to larynx cancer. Pain and mood scores of visual analogue scale(VAS) reduced significantly in all patients and no severe complications occurred. Conclusion:CT-guided cervical approach radiofrequency neurolysis is a safe and effective procedure in treating GPN with characters of high reliability, accurate location, good operational safety and fewer complications. |
Keywords:glossopharyngeal neuralgia CT-guided puncture radiofrequency neurolytic block |
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