[1]张文斗,范　波,胡会敏,等.原发性三叉神经痛微血管减压术后复发的影响因素分析[J].中国临床神经外科杂志,2019,(04):221-223.[doi:10.13798/j.issn.1009-153X.2019.04.010]
　ZHANG Wen-dou,FAN Bo,HU Hui-min,et al.Factors related to recurrence of primary trigeminal neuralgia after microvascular decompression[J].,2019,(04):221-223.[doi:10.13798/j.issn.1009-153X.2019.04.010]
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原发性三叉神经痛微血管减压术后复发的影响因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年04期
页码:
221-223
栏目:
论著
出版日期:
2019-04-27

文章信息/Info

Title:
Factors related to recurrence of primary trigeminal neuralgia after microvascular decompression
文章编号:
1009-153X（2019）04-0221-03
作者:
张文斗; 范　波; 胡会敏; 苏　睿
471000 河南洛阳，河南科技大学第一附属医院神经外科（张文斗、范　波）；471000 河南洛阳，河南科技大学第二附属医院神经外科（胡会敏、苏　睿）
Author(s):
ZHANG Wen-dou1;  FAN Bo1;  HU Hui-min2;  SU Rui2.
1. Department of Neurosurgery, The First Affiliated Hospital, He’nan University of Sciences and Technology, Luoyang 471000, China; 2. Department of Neurosurgery, The Second Affiliated Hospital, He’nan University of Sciences and Technology, Luoyang 471000, China
关键词:
原发性三叉神经痛; 微血管减压术; 复发; 影响因素
Keywords:
Primary trigeminal neuralgia;  Microvascular decompression;  Recurrence;  Influencing factors
分类号:
R 739.41; Q 786
DOI:
10.13798/j.issn.1009-153X.2019.04.010
文献标志码:
A
摘要:
目的 探讨微血管减压术（MVD）治疗原发性三叉神经痛（PTN）的疗效及术后复发的影响因素。方法 回顾性分析2014年1月至2017年1月MVD治疗的164例PTN的临床资料。术后随访12~48个月， 中位随访时间31个月。采用巴罗神经学研究所（BNI）面部疼痛分级标准评估疗效。采用多因素Logistic回归分析检验术后复发的影响因素。结果 术后1周BNI分级Ⅰ~Ⅱ级139例（84.76%），Ⅲ级25例 （15.24%）；术后11例（6.70%）出现并发症。随访期间共复发31例，复发率为18.90%。多因素Logistic回归分析显示，病程≥5年、减压未充分、压迫有移位是影响PTN病人MVD后复发的独立危险因素 （P<0.05）。结论 MVD治疗PTN临床疗效确切，安全性较高；对于病程长、未充分减压的病人，应注意加强随访，防治复发。
Abstract:
Objective To explore the factors related to the recurrence of primary trigeminal neuralgia (PTN) after microvascular decompression (MVD). Methods The clinical data of 164 patients with PTN who underwent MVD in department of neurosurgery of our hospital from January, 2014 to January, 2017 were analyzed retrospectively. The factors related to the recurrence were statistically analyzed in the patients. Results The facial pain belonged in grades Ⅰ~Ⅱ in 139 patients (84.76%) and grades Ⅲ 25 (15.24%) 1 weeks after MVD according to Barow Neurological Institute pain grade. There were the postoperative complications including facial numbers, herps of corners of the mouths, hearing disturbance and taste deficiency in 11 patients. The trigeminal recurred 12~48 months after MVD in 31 patients. Multivariable Logistic regression analysis showed that the independent risk factors related to the recurrence included the disease duration≥5 years, insufficient decompression, and displacement of compression in patients with PTN (P<0.05). Conclusions The curative effect of MVD on PTN and its safety are good. It is necessary to pay high attention to the risk factors related to the recurrence in the patients with PTN.

参考文献/References:

[1] 权俊杰，屈建强，周　乐，等. 微血管减压术与感觉根部分 切断术联合治疗原发性三叉神经痛效果观察[J]. 解放军 医药杂志，2016，28（1）：73-76.
[2] 张　斌，张良文，迟令懿，等. 显微血管减压术治疗原发性 三叉神经痛疗效的相关因素[J]. 山东大学学报：医学版， 2016，54（6）：69-72.
[3] 杜　权，俞文华，胡　强. 微血管减压术联合电凝术与单 纯微血管减压术治疗原发性三叉神经痛的疗效比较[J]. 浙江医学，2016，38（5）：329-331.
[4] 张萌萌，王　玲. 三叉神经痛病人行显微外科微血管减压 术治疗的临床效果及护理配合[J]. 实用临床医药杂志， 2016，20（20）：53-55.
[5] 苏忠周，周　跃，沈　健，等. 微骨孔枕下乙状窦后入路显 微血管减压术治疗45例三叉神经痛[J]. 中华显微外科杂 志，2016，39（5）：481-483.
[6] 方　立，单国用，张　松，等. 伽玛刀治疗三叉神经痛显 效、复发时间及安全性的生存分析[J]. 国际神经病学神 经外科学杂志，2017，44（3）：252-256.
[7] Alves TC, Azevedo GS, Carvalho ES. Pharmacological treat- ment of trigeminal neuralgia: systematic review and met- analysis [J]. Rev Bras Anestesiol, 2004, 54(6): 836-849.
[8] Han PP, Shetter AG, Smith KA, et al. Gamma knife radio- surgery for trigeminal neuralgia: experience at the Barrow Neurological Institute.[J]. Stereotact Funct Neurosurg, 2000, 47(4): 1013-1019.
[9] 刘厚强，孟庆明，叶成坤，等. 微血管减压术治疗原发性 三叉神经痛预后影响因素分析[J]. 中华神经医学杂志， 2018，17（4）：402-405.

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备注/Memo

备注/Memo:
（2018-07-18收稿，2018-10-30修回）
更新日期/Last Update: 2019-04-27