微血管减压治疗颅神经根压迫性疾病的远期效果观察

Long-Term Outcome Observation of Microvascular Decompression in the Treatment of Cranial Nerve Compression Disease

摘要: 目的：评价微血管减压治疗颅神经根压迫性疾病的远期疗效。方法：纳入3家神经外科中心2013年10月~2023年10月间采用微血管减压术治疗神经血管压迫综合征的病人，其中三叉神经痛937例，面肌痉挛1264例，舌咽神经痛211例。随访年限6个月~10年。通过远期随访，评估微血管减压治疗此类疾病的远期效果。结果：微血管减压治疗三叉神经痛的总有效率为91.36%，治疗面肌痉挛的总有效率为89.08%，治疗舌咽神经痛总有效率为94.31%。远期效果观察中三叉神经痛术后复发率为20.38%。面肌痉挛复发率14.87%，舌咽神经痛术后复发率21.80%。结论：微血管减压术为治疗神经血管压迫综合征的首选术式，后颅窝神经血管变异较多依旧是此类疾病手术的难点。熟练掌握内镜辅助技术以及术中应用多变的减压方式是提高此类疾病手术有效率和减少并发症的关键。

Abstract: Objective: To evaluate the long-term outcome of microvascular decompression in the treatment of neurovascular compression syndromes. Methods: Patients with neurovascular compression syndromes treated by microvascular decompression in three neurosurgical centers from October 2013 to October 2023 were included, including 937 cases of trigeminal neuralgia, 1264 cases of hemifacial spasm, and 211 cases of glossopharyngeal neuralgia. The follow-up period ranged from 6 months to 10 years. Evaluate the long-term efficacy of microvascular decompression treatment for this type of disease through long-term follow-up. Results: the effective rate of 937 patients with trigeminal neuralgia was 91.36%. The effective rate of 1264 patients with hemifacial spasm was 89.08%. The effective rate of 211 patients with glossopharyngeal neuralgia was 94.31%. The recurrence rate of trigeminal neuralgia was 20.38% in the long-term effect observation. The recurrence rate of hemifacial spasm was 14.87%, and the recurrence rate of glossopharyngeal neuralgia was 21.80%. Conclusion: microvascular decompression is the preferred surgical treatment for neurovascular compression syndromes, and more neurovascular variations are still the difficulties in the operation of this kind of disease. Endoscope-assisted microvascular decompression for the treatment of neurovascular compression syndromes has advantages and techniques, which may reduce the incidence of surgical complications while improving the curative effect and reducing the recurrence rate.