时间偏头痛的最少侵入性神经和动脉节省手术方法
Giorgio Pietramaggiori1, Alessandro Bastin2, Federico Ricci2
1Global Medical Institute, Division of Aesthetic and Migraine Surgery, Avenue Jomini 8, 1004 Lausanne, Switzerland.
JPRAS open
|January 1, 2024
概括
微创手术通过保护神经和动脉,有效治疗时间性偏头痛 (TM). 在耐药TM患者中,节约神经的技术显著减少了每月的偏头痛日数.
科学领域:
- 神经学 神经学
- 手术创新 在外科创新.
- 血管外科 血管外科
背景情况:
- 时间性偏头痛 (TM) 导致令人虚弱的头痛.
- 目前对TM的手术选择,包括耳角神经 (ATN) 切除或表面动脉 (STA) 绑定,显示出良好的结果.
- 建议采用一种最小入侵的方法来保护血管和神经结构.
研究的目的:
- 评估对抗药物时间偏头痛的最小侵入性手术技术的疗效.
- 为了比较神经节约与神经和动脉节约的方法.
- 为了研究TM患者表面动脉的组织学发现.
主要方法:
- 57名耐药TM患者接受了神经节约性解压或神经和动脉节约性动脉溶解治疗.
- 通过在至少一年后量化TM改善来评估结果.
- 表面动脉 (STA) 活检经过组织学分析.
主要成果:
- 神经节约性减压 (42名患者) 取得了78.6%的成功率,使偏头痛日数从每月22.1日减少到6.2天.
- 神经和动脉节约性动脉溶解 (15名患者) 显示了86.6%的成功率,80%的人经历了90%以上的改善,并将偏头痛天数从每月24天减少到2.5天.
- 在75%的样本中发现了STA内纤维化,但与症状严重程度或手术结果无关.
结论:
- 最少侵入性,节约神经的手术方法对耐药TM有效且安全.
- 在TM患者中,STA内纤维化是常见的,但不能预测手术结果.
- 由于患者数量有限,需要进一步的研究来验证神经和动脉节省技术.
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