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目的 探讨伽玛刀治疗三叉神经痛（ＴＮ） 的方法和疗效。方法 采用１－５ Ｔ ＭＲ 影像、ＧａｍｍａＰｌａｎ 定位和治疗计划，Ｌｅｋｓｅｌｌ 伽玛刀（γ刀） 治疗７５ 例ＴＮ，其中６５ 例非肿瘤性ＴＮ，治疗靶点在三叉神经感觉根入桥脑区，单个４ ｍｍ 准直器，中心剂量７０～９０ Ｇｙ，５０ ％ 等剂量线限定靶点；１０ 例颅底肿瘤性三叉神经痛以肿瘤为照射靶区，中心剂量２０ ～３０ Ｇｙ，周边剂量１０ ～１５ Ｇｙ。结果 随访３ ～３８ 个月，全组疗效优者占５７－３％ ，良占３０－７ ％ ，有效占５－３％ ，总有效率９３－３％ ，非肿瘤性ＴＮ总有效率９２－３ ％ 。４ 例于５ ～１７ 个月疼痛复发。全组病人无任何并发症，无死亡。结论 伽玛刀是治疗三叉神经痛安全和有效的治疗方法。
Objective To investigate the method and efficacy of gamma knife in the treatment of trigeminal neuralgia (TN). Methods Totally 1-5 T MR imaging, Gamma-Plan localization and treatment planning were performed. Leksell gamma knife was used to treat 75 cases of TN, of which 65 cases were non-neoplastic TN. Area, a single 4 mm collimator, the center dose of 70 ~ 90 Gy, 50% isodose line limit targets; 10 cases of skull base tumor of trigeminal neuralgia with tumor as the target area, the central dose of 20 ~ 30 Gy, peripheral dose 10 ~ 15 Gy. Results The follow-up ranged from 3 to 38 months. The overall effective rate was 57.3%, good in 30-7%, effective in 5-3%, total effective rate 93-3%, and non-neoplastic TN in total 92- 3%. 4 cases of pain recurrence in 5 to 17 months. All patients without any complications, no death. Conclusion Gamma knife is a safe and effective treatment for trigeminal neuralgia.