三叉神经微血管减压术后口角疱疹原因及治疗探析.docVIP

三叉神经微血管减压术后口角疱疹原因及治疗探析[摘要] 目的：探讨三叉神经微血管减压术后出现口角疱疹的原因及其治疗。方法：回顾性分析在本院住院的34例三叉神经痛患者，均行微血管减压术，术后有3例患者出现口角疱疹，分析发病原因，并予局部用药及静脉抗病毒用药，观察其疗效。结果：经过治疗后，病程1周后疱疹萎缩、消退。无无效病例，有效率为100%。结论：三叉神经微血管减压术后出现口角疱疹，与术中骚扰三叉神经，激活神经节细胞内的疱疹病毒有关，经抗病毒治疗，效果良好。预防此并发症，主要减少术中对三叉神经的骚扰及损伤。 [关键词] 三叉神经痛；微血管减压；并发症；疱疹 [中图分类号] R781 [文献标识码]A[文章编号]1674-4721（2011）02（c）-044-02 The factors lead to facial herpes zoster by microvascular decompression of the trigeminal nerve and the treatment for that GU Jiyong, WU Yi, LI Zhibin, FENG Zhengjian, TAN Linqiong, DING Xiao, HUANG Ge, DONG Jiajun, PENG Yilong, LUAN Zhongqin (Department of Neurosurgery, Jiangmen Central Hospital of Guangdong Province, Jiangmen 529000, China) [Abstract] Objective: To explore the factors lead to facial herpes zoster by microvascular decompression (MVD) of the trigeminal neuralgia (TN) and the treatment for that. Methods: Thirty-four cases of MVD were analyzed retrospectively. There were three cases that develop facial herpes zoster within two to four days after the operation. Analyzed the factors lead to that, and treat by vein and part, reseatch the curative effect. Results: Facial herpes zoster was healing well after the treatment. Conclusion: The facors of facial herpes zoster by microvascular decompression (MVD) of the trigeminal neuralgia (TN) are mainly caused by the stimulus to the TN and activate the virus in the ganglion cell during the surgery. After anti virus treatment, facial herpes zoster healing well. The main precaution is reducing the stimulus or damage to the trigeminal nerve. [Key words] Trigeminal neuralgia; Microvascular decompression; Complication; Facial herpes zoster 原发性三叉神经痛（primary trigeminal neuralgia）是以面部发作性疼痛为特征的神经系统疾病，年发病率约为每10万人1例，老年人70～80岁，年发病率为每10万人33例左右，40岁以下则是每10万人0.2例，女性略多于男性。近年来随着微创显微神经外科技术的发展，已有不少国内外学者用手术的方法为这些患者减轻痛苦并取得了成功，但是术后并发口角疱疹情况时有发生。回顾分析近2006年1月~2010年12月在本院住院治疗的34例三叉神经痛患者，行微血管减压术后出现口角疱疹的病例，探讨其发病原因及治疗办法。 1 资料与方法 1.1 一般资料 本组34例三叉神经痛患者，其中，男15例，女19例，年龄38～81岁，平均59.5岁