Mikrovaskularna dekompresija je učinkovita in varna metoda zdravljenja trigeminusne nevralgije pri starejših bolnikih
Ključne besede:
nevralgija, trigeminus, mikrovaskularna dekompresija, učinkovitost, varnostPovzetek
Izhodišča: Namen študije je bil ugotoviti, ali obstaja pomembna razlika v uspešnosti zdravljenja trigeminusne nevralgije (TN) z mikrovaskularno dekompresijo (MVD) med skupino bolnikov, starih 65 let ali mlajših, in skupino starejših od 65 let in določiti učinkovitost in varnost te metode pri starejših bolnikih.
Metode: 40 bolnikov smo operirali zaradi trdovratne tipične TN in pri vseh naredili MVD trigeminusa. Ocenili smo olajšanje bolečine takoj po operaciji in 2 leti po MVD pri 22 bolnikih, starejših od 65 let, in pri 18 bolnikih, mlajših od 65 let. Pri obeh skupinah smo upoštevali še druge dejavnike: trajanje bolečine pred MVD, telesna pripravljenost bolnikov za operacijo, vrsta žile (arterija ali vena), ki je povzročila pritisk na trigeminus, trajanje bolnišničnega zdravljenja in pooperativne zaplete.
Rezultati: Med obema skupinama ni bilo statistično pomembne razlike pri olajšanju bolečine takoj in 2 leti po MVD (P = 0,381, P = 0,185). Dve leti po MVD je bilo skupaj več bolnikov brez bolečine pri arterijskih kompresijah kot pri venskih (P < 0,001). Mlajši bolniki so bili bolje telesno pripravljeni kot starejši (P = 0,027). Trajanje zdravljenja je bilo krajše pri mlajši skupini bolnikov (P < 0,001). V nobeni skupini ni bilo operativne umrljivosti, okvare možganskih živcev ali drugih resnejših nevroloških zapletov.
Zaključki: Mikrovaskularna dekompresija je učinkovita in varna metoda zdravljenja trigeminusne nevralgije tudi pri starejših bolnikih. Učinkovitost metode je večja v primerih pritiska arterije na trigeminus. MVD je metoda izbire zdravljenja TN tudi pri starejših telesno dobro pripravljenih bolnikih.
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