CCTV international 065438+2005 10 month
1, chief physician Ma Yi, director of the Second Department of Neurosurgery, People's Hospital of Liaoning Province, participated in and completed more than 2,000 cases of intracranial tumor and craniocerebral trauma surgery. At present, he is mainly engaged in the surgical treatment and research of intractable trigeminal neuralgia and various chronic intractable neuralgia (left).
2. Li Yanfeng, deputy chief physician, graduated from China Medical University and participated in and completed nearly 2,000 cases of neurosurgery. Now he is mainly engaged in the surgical treatment of various chronic intractable pains such as trigeminal neuralgia (right).
Moderator: Hello, audience friends! This is CCTV's live program "The Road to Health", and today we are going to talk about trigeminal neuralgia.
Narrator: Today we met several patients suffering from pain here.
Patient child: The pain is unimaginable. I can't resist it.
Narrator: Tong Lan Zhi is 58 years old and has had pain in his left cheek for three years.
Patient Wen Zhenxing: Go to the hospital when it hurts, and don't walk.
Narrator: Wen Zhenxing was 72 years old and his right cheek stung for a year.
Patient Cui Yan: I want to die as soon as I feel pain. Please, I don't want anything.
Narrator: Cui Yan is 47 years old, and her left cheek seems to have hurt for five years.
Narrator: The severe pain experienced by these patients is beyond ordinary people's understanding and imagination.
Moderator: Why is trigeminal neuralgia so serious?
Ma Yi: First of all, let's learn about the trigeminal nerve. Trigeminal nerve is a pair of sensory nerves, which are distributed on both sides of human head. The trigeminal nerve can be divided into three branches. The first branch is the ophthalmic branch, which dominates the eyeball and some parts above the eyeball. The second branch is called maxillary branch, which dominates the skin from eye fissure to mouth fissure, including the alar part, and the third branch is also called mandibular branch, which dominates the lower part. Trigeminal neuralgia can occur in all these areas. Trigeminal neuralgia can be roughly divided into two categories, one is called secondary trigeminal neuralgia, which means that a clear cause can be found through current examination methods. Usually what we call trigeminal neuralgia mainly refers to another kind, which we call primary trigeminal neuralgia, that is to say, no clear cause has been found so far. In fact, the cause of trigeminal neuralgia is not particularly clear so far. The function of trigeminal nerve mainly dominates the sensory functions in this area, such as facial sensation and tongue sensation.
Li Yanfeng: Many patients describe trigeminal neuralgia as the first pain in the world, which is very painful. Patients usually describe this kind of pain as tingling sensation, electric sensation, tearing sensation and so on. In addition, many patients will have symptoms such as drooling and facial convulsions when they are in pain, which is very painful.
Ma Yi: The most common parts of trigeminal neuralgia are in the second and third branches. Many patients show toothache or pain near the mouth and nose.
Li Yanfeng: Many patients can't brush their teeth, wash their faces and talk when they are in pain, so their normal work and life can't be carried out. In addition, patients suffering for too long will also have mental symptoms, such as depression and mania. Foreign statistics show that more than 50% of patients have suicidal tendencies when they are in pain.
Moderator: See a patient:
Narrator: Teacher Zhang, who works in fine arts, is a cheerful person in everyone's eyes. Unfortunately, something unexpected happened. In the autumn of 2000, Lao Zhang was a little worried about his physical discomfort.
Mr Zhang: I suddenly feel a toothache. As long as the toothbrush is handed here and touched here, it is just like acupuncture, which is worse than acupuncture. It hurts my brain and my heart.
Narrator: After visiting large and small hospitals, Mr. Zhang decided to pull out the two most painful teeth on weekdays.
Mr. Zhang: I still can't pull out my tooth. It still hurts to go home for dinner. Later the doctor told me it was trigeminal neuralgia.
Li Yanfeng: We often meet such patients who have taken many detours in treatment.
Ma Yi: It is not difficult for professional doctors to distinguish trigeminal neuralgia from other diseases, because trigeminal neuralgia has its own characteristics. For example, the onset must be in the area where the trigeminal nerve is located. The general attack time, especially the prophase, is usually a few seconds or a minute at a time. After an attack, there may be a long interval, and the pain is particularly severe. Of course, facial pain is not just trigeminal neuralgia, such as toothache, which we often say. Toothache is generally persistent pain. If necessary, go to the dentist for anti-inflammatory treatment for a few days. Another thing that needs to be identified is migraine, which is also a kind of persistent pain. The general attack is 4-72 hours, and it is jumping pain. The frequency of jumping is the same as the fluctuation of blood vessels. Every migraine attack will be accompanied by symptoms such as nausea, vomiting and inability to see clearly.
Characteristics of trigeminal neuralgia
1, recurrent attack
2. The onset duration is short and the pain is severe.
3. All tests are normal.
Moderator: Let's see how patients with trigeminal neuralgia treat this disease:
Patient: I dare not wash my face, brush my teeth, eat, and only wipe half my face when I wash my face.
Patient: I take a hot bath once a week and I am sweating all over. I may get better after sweating.
Patient: after being closed, this half-pulled face is numb and nothing smells good. The face is like a piece of wood.
Ma Yi: Trigeminal neuralgia is a disease that is difficult to heal itself once it is ill. Patients should take more active treatment.
Li Yanfeng: Trigeminal neuralgia will become more and more serious in the later stage. Not to mention work, even normal life can't be carried out.
Moderator: What are the treatment methods for trigeminal neuralgia?
Ma Yi: The treatment of trigeminal neuralgia can be roughly divided into three methods. The first is drug therapy, and the main drug is carbamazepine. Carbamazepine is an analgesic for trigeminal neuralgia, but long-term application may have some side effects, so we do not advocate long-term medication.
Li Yanfeng: The second treatment method is traditional craniotomy, which makes a hole behind the ear and performs microvascular decompression on the trigeminal nerve root. This operation has a history of 30 to 40 years and has cured thousands of patients. But trigeminal neuralgia itself is a senile disease, and the patients are generally older. There may be some other senile diseases, such as hypertension, diabetes, heart disease and so on. , can not adapt to the operation, so the risk is relatively high.
Ma Yi: An American doctor invented interventional therapy for trigeminal neuralgia on the basis of many studies, which was welcomed by patients and doctors. The biggest feature of interventional therapy is that it does not require surgery. As shown in the figure, the patient is anesthetized first, then the puncture point is selected on the patient's face, the balloon catheter is inserted through the puncture needle, and the balloon is properly compressed at the nerve root node, and the operation is completed. This is a short and safe process. This technology has been developed abroad for more than 20 years. Our hospital started at the end of 2000 and has developed in China for more than four years. At present, our Liaoning Provincial People's Hospital is the only hospital that has the ability to complete this treatment.
Compere: Is the operation risky?
Li Yanfeng: This operation is general anesthesia. It is a small minimally invasive puncture point, with almost no trauma and almost no risk to patients. According to foreign statistics, so far no patients have died because of this treatment.
Ma Yi: Our hospital has treated nearly 700 patients in China. So far, no one has died because of this operation.
Moderator: Which patients can receive interventional therapy?
Li Yanfeng: Trigeminal neuralgia can be divided into two categories, one is primary trigeminal neuralgia and the other is secondary trigeminal neuralgia. Our interventional therapy is suitable for all patients with primary trigeminal neuralgia. In addition, for the treatment of patients with secondary trigeminal neuralgia, we have also made some attempts and achieved certain results, but we still suggest that patients get rid of the cause first.
Moderator: Do patients need to be hospitalized after treatment?
Li Yanfeng: This is a general anesthesia operation. Generally speaking, all patients need hospitalization. The operation time is short, so the recovery time is short. The average patient can leave the hospital in 3-5 days.
Moderator: How much is the treatment fee?
Li Yanfeng: The total cost of surgery from hospitalization to discharge is about 7,000 yuan.
Moderator: Are there any side effects from the operation?
Ma Yi: Generally speaking, the side effects of this interventional therapy are relatively few. The problem we often encounter is that after treatment, patients report a slight numbness, which will gradually improve and generally gradually improve. In the process of treatment, we are also gradually exploring the problem of better handling of complications, and the situation will definitely get better and better.
Moderator: Will it recur after interventional therapy?
Li Yanfeng: At present, all the treatments for trigeminal neuralgia have a certain recurrence rate, but after years of exploration, we have now controlled the recurrence rate within 5% (about 700 cases in total). It can be treated again after recurrence.
Moderator: Ms. Xu from Sichuan, 84 years old. I suffer from trigeminal neuralgia for more than 30 years, as well as diabetes, coronary heart disease and hypertension. Can I use this therapy?
Ma Yi: This method can be completely adopted. The oldest patient we met is 97 years old. Many patients come after many other treatments with poor results, and the interventional therapy has a very good effect.
Moderator: Tel: (024)24 160344, 2410/4175; Outpatient time: Aunt Ma is all day on Monday, and Li Yanfeng is all day on Tuesday.
References:
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