目的 观察射频热凝术治疗难治性眶上神经痛的效果。方法 2007年2月至2014年9月,对36例药物及神经阻滞治疗无效的难治性眶上神经痛患者行射频热凝术治疗。记录治疗前,治疗后1 d、1个月、3个月、6个月、1年和2年时的疼痛数字评分(NRS)和患者满意度评分(PSS),以治疗后患者NRS=0或NRS降低50%以上为标准记录起效时间、有效率以及复发情况,并记录卡马西平的用量和副作用。结果 患者治疗后平均2 d (0~7 d)起效,与治疗前比较NRS评分下降(P<0.05),PSS评分提高(P<0.05),6个月内有效率100%。2年内复发率为11.1%,患者复发后再次行射频热凝术治疗仍然有效。除额面部麻木、短期内眼睑水肿、瘀斑外无其他副作用发生。结论 射频热凝术治疗难治性眶上神经痛患者有效,副作用可耐受,是保守治疗无效患者的一种治疗选择。
Objective To observe the effect of radiofrequency thermocoagulation on patients with refractory supraorbital neuralgia Methods From February, 2007 to September, 2014, 36 patients with refractory supraorbital neuralgia following ineffective conservative therapy including medicine and nerve blockade underwent radiofrequency thermocoagulation. Numeric Rating Scale (NRS), Patient Satisfaction Scale (PSS), onset time, effective rate, recurrence rate, additional carbamazepine dosage and side effects were recorded before, and one day, one month, three months, six months, one year, two years after treatment. NRS=0 or 50% diminution was considered effectively. Results It worked two days on average (zero to seven) after treatment. The NRS score decreased (P<0.05) and the PSS score increased (P<0.05) compared with the data before treatment. The effective rate was 100% within six months. The recurrence rate was 11.1% within two years. Second radiofrequency thermocoagulation treatment still worked for the recurrent patients. No other side effect was observed, except permanent frontal numbness, short-time palpebral edema and ecchymosis. Conclusion Radiofrequency thermocoagulation is effective on refractory supraorbital neuralgia, and the side effects are tolerable so it is an alternative choice for patients experiencing invalid conservative therapy.
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