收稿日期: 2024-10-16
网络出版日期: 2025-01-26
基金资助
河南省医学科技攻关计划项目(LHGJ20191 477);南阳市科技攻关计划项目(23KJGG161)
Changes in the ocular surface of patients with trigeminal neuralgia treated with percutaneous balloon compression of the trigeminal ganglion
Received date: 2024-10-16
Online published: 2025-01-26
目的 探讨经皮球囊压迫三叉神经节治疗三叉神经痛（trigeminal neuralgia， TN）对眼表的影响。 方法 收集自2023年5月至2024年6月诊断为TN并行球囊压迫术的患者共30例60只眼。术前1 d、术后1 d分别检查双眼的角膜知觉、泪液分泌试验（Schirmer Ⅰ test）、泪膜破裂时间（tear break-up time， TBUT）、角膜荧光素染色评分。 结果 TN患者双眼泪液分泌值和TBUT低于正常值。术前1 d双眼各项检查差异无统计学意义（P = 0.144，P = 0.072，P = 0.069，P = 1.000）；术后1 d患侧眼角膜知觉、泪液分泌值、TBUT较对侧眼显著下降（P < 0.01，P < 0.01，P < 0.01），荧光素染色评分较对侧眼略升但差异无统计学意义（P = 0.157）。与术前比，术后患侧眼角膜知觉、泪液分泌值、TBUT显著下降（P < 0.01，P < 0.01，P < 0.01），荧光素评分略升但差异无统计学意义（P = 0.157）。 结论 TN患者双眼泪液分泌量低、泪膜稳定性差。行球囊压迫术后，患侧眼角膜知觉减弱，泪液分泌量与泪膜稳定性进一步下降。因此，建议TN患者无论手术与否均需眼科干预、治疗及随访。
刘睿 , 王世娟 , 郑铁牛 , 陈文生 . 经皮球囊压迫三叉神经节治疗三叉神经痛对患者眼表的影响[J]. 实用医学杂志, 2025 , 41(2) : 215 -219 . DOI: 10.3969/j.issn.1006-5725.2025.02.009
Objective To investigate the effect of percutaneous balloon compression on the ocular surface in the treatment of trigeminal neuralgia （TN）. Methods A total of 30 patients （60 eyes） diagnosed with TN who underwent parallel balloon compression surgery from May 2023 to June 2024 were included in the study. Corneal sensation， Schirmer I test results， tear film break-up time （TBUT）， and corneal fluorescein staining scores were evaluated in both eyes one day before and one day after the surgery. Results The tear secretion values and TBUT in both eyes of TN patients were lower than normal. Preoperatively， there were no statistically significant differences in various ocular examinations between the two eyes （P = 0.144， P = 0.072， P = 0.069， P = 1.000）. One day postoperatively， the corneal sensitivity， tear secretion value， and TBUT of the affected eye were significantly lower compared to the contralateral eye （P < 0.01， P < 0.01， P < 0.01）， while the fluorescein staining score showed a slight increase but was not statistically significant （P = 0.157）. Compared to preoperative levels， the postoperative corneal sensitivity， tear secretion value， and TBUT of the affected side were significantly reduced （P < 0.01， P < 0.01， P < 0.01）， while the fluorescein staining score showed a slight increase but remained non?significant （P = 0.157）. Conclusions TN patients patients exhibit reduced bilateral tear secretion and compromised tear film stability. Following balloon compression surgery， the corneal sensitivity of the affected eye diminishes， leading to a further decline in tear secretion and tear film stability. Consequently， it is imperative that TN patients receive ophthalmic intervention， treatment， and regular follow?up， irrespective of whether they undergo surgery.
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