Hiệu quả điều trị và biến chứng tiêm phong bế thần kinh V bằng cồn tuyệt đối liều thấp trên bệnh nhân đau dây thần kinh V nguyên phát=Effectiveness and complication of low-dose trigeminal nerve block with alcohol in idiopathic trigeminal neuralgia

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Thu Hà Bùi, Tiến Lưu Đoàn, Văn Hướng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Thần kinh học, 2024

Mô tả vật lý: tr.44-50

Bộ sưu tập: Báo, Tạp chí

ID: 241682

Thêm vào giỏ

Tiêm phong bế dây thần kinh V bằng cồn tuyệt đối đã được biết đến từ lâu như một phương pháp điều trị bệnh đau dây thần kinh V. Tuy nhiên, có rất ít thông tin trong tài liệu liên quan đến tiêm phòng bế dây thần kinh V bằng cồn tuyệt đối, do đó, chúng tôi đã tiến hành nghiên cứu đánh giá hiệu quả và các biến chứng liên quan của việc phong bế bằng cồn tuyệt đối liều thấp trong điều trị đau dây thần kinh V nguyên phát. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu và tiến cứu trên 38 người bệnh được chẩn đoán xác định là đau dây thần kinh V nguyên phát được can thiệp tiêm phong bế thần kinh V bằng cồn tuyệt đối liều thấp tại Bệnh viện Đại học Y Hà Nội từ tháng 1 năm 2019 đến tháng 7 năm 2022. Kết quả: 38 bệnh nhân được tiêm cồn tuyệt đối trong điều trị đau dây thần kinh V từ tháng 1 năm 2019 đến tháng 7 năm 2022. Trong đó, có 30 trường hợp tiêm cồn liều 0,3 ml và 8 trường hợp với liều lớn hơn 0,3 ml. Thang điểm đánh giá đau trực quan (VAS) từ mức độ trung bình (điểm VAS từ 5-6 điểm) với 18 trường hợp và mức độ nặng (điểm VAS từ 7-10 điểm) với 12 trường hợp trước can thiệp, kết quả sau can thiệp có tổng cộng 24 bệnh nhân cải thiện mức độ đau nhẹ (điểm VAS 1-4 điểm) hoặc không đau (điểm VAS 0 điểm). Có 30 (100%) người bệnh không trải qua cơn đau tái phát trong vòng tối thiểu một năm. Sử dụng thang điểm đánh giá cường độ đau của Viện Thần kinh học Barrow (BNI-PS), sau 2 tuần chỉ có 2 trường hợp đau tái phát ghi nhận mức BNI-PS IV (6,7%), sau 12 tháng có 2 trường hợp đau tái phát mức độ điểm BNI-PS IV (6,7%), sau trên 12 tháng có 5 trường hợp đau tái phát mức độ điểm BNI-PS IV (17,2%) và 1 trường hợp với BNI-PS V (3,4%). Không có biến chứng nghiêm trọng nào được báo cáo. Tê bì mặt được báo cáo trong 16 trường hợp (53,3 %) với liều 0,3 ml và 8 trường hợp với liều lớn hơn 0,3 ml (87,5%). Các biến chứng khác bao gồm: viêm giác mạc ở 4 trường hợp (13,3%) trường hợp với liều 0,3 ml và 2 trường hợp (25%) với liều lớn hơn 0,3ml, yếu cơ cắn ở 7 trường hợp (23,3%) với liều 0,3ml và 2 trường hợp (25%) với liều lớn hơn 0,3 ml.Trigeminal nerve block with alcohol was introduced long ago as a treatment method for trigeminal neuralgia. However, very little information is available in the literature regarding trigeminal nerve block with alcohol, and therefore, we evaluated the efficacy and related complications of an alcohol block of the trigeminal nerve for the treatment of indiopathic trigeminal neuralgia. Subjects and methods: Longitudinal and retrospective study in 38 idiopathic trigeminal neuralgia patients with low-dose trigeminal nerve block with alcohol from January 2019 to July 2022. Results: 38 patients were analyzed who received absolute alcohol injections in the management of trigeminal neuralgia (TN) from January 2019 to July 2022. There are 30 cases were injected with 0,3 ml of absolute alcohol and 8 cases with a greater 0,3 ml dose. The visual analogue scale (VAS) was used for pain improved with moderate level (18 cases) and severe level (12 cases) before, 24 patients had marked improvement of pain with mild level or free from pain. 30 patients (100%) who initially became free from pain experienced a recurrence of pain at least 1 year. Using the Barrow Neurologic Institude pain scale (BNI-PS), after 2 weeks there were only 2 patients (6,7%) experienced recurrent pain with BNI-PS IV, 2 patients (6,7%) with BNI-PS IV after 12 months and 5 patient (17,2%) with BNI-PS IV, 1 patient with BNI-PS V (3,4%) after more than 12 months. No serious complications were reported. Facial numbness was reported in 16 cases (53,3%) with 0,3 ml of absolute alcohol and 8 cases (87,5%) with a greater 0,3 ml dose. Other complications included: keratitis in 4 cases (13,3%) with 0,3 ml of absolute alcohol and 1 cases (25%) with a greater 0,3 ml dose, masseter muscle weakness in 7 cases (23,3,%) with 0,3 ml of absolute alcohol and 2 cases (25,5%) with a greater 0,3 ml dose.

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