[1]秦磊,邹元杰,徐晨光,等.三叉神经痛微血管减压术远期疗效的影响因素研究[J].临床神经外科杂志,2020,17(03):317-322.[doi:DOI:10.3969/j.issn.1672-7770.2020.03.016]
 QIN Lei,ZOU Yuan-jie,XU Chen-guang,et al.Analysis on contributing factors affecting long-term effectiveness of microvascular decompression for trigeminal neuralgia[J].Journal of Clinical Neurosurgery,2020,17(03):317-322.[doi:DOI:10.3969/j.issn.1672-7770.2020.03.016]
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三叉神经痛微血管减压术远期疗效的影响因素研究()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
17
期数:
2020年03期
页码:
317-322
栏目:
论著
出版日期:
2020-06-15

文章信息/Info

Title:
Analysis on contributing factors affecting long-term effectiveness of microvascular decompression for trigeminal neuralgia
文章编号:
202003016
作者:
秦磊邹元杰徐晨光肖勇耿良元刘永胡新华
210029 南京,南京医科大学附属脑科医院神经外科
Author(s):
QIN Lei ZOU Yuan-jie XU Chen-guang et al.
Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
关键词:
微血管减压术三叉神经痛手术疗效预测因素
Keywords:
microvascular decompression trigeminal neuralgia surgical effect predictor
分类号:
R745.1+1
DOI:
DOI:10.3969/j.issn.1672-7770.2020.03.016
文献标志码:
A
摘要:
目的探讨原发性三叉神经痛微血管减压术(microvascular decompression,MVD)术后远期疗效的影响因素;以提高MVD治疗三叉神经痛的效果。方法回顾性分析南京医科大学附属脑科医院神经外科2014年1月—2019年11月,行MVD治疗的99例原发性三叉神经痛患者的临床资料。通过门诊及电话对患者的术后疗效进行随访。分析术前、术中各因素与疗效的关系,筛选出相关因素再纳入多因素Cox回归模型,分析术后疗效的影响因素。结果本组患者中,有86例术后近期完全无疼痛(BNI Ⅰ),近期治愈率达86.9%。Kaplan-Meier生存分析结果显示,患者术后1年、3年、5年的疼痛缓解率分别为86.7%、73.9%、70.7%。多因素Cox回归分析结果显示,年龄≥60岁(P=0.03)、病程<5年(P=0.011)、动脉压迫(动静脉联合vs动脉,P=0.006;静脉vs动脉,P=0.007)和典型性三叉神经痛(P=0.02)是远期良好预后的独立预测因素。结论原发性三叉神经痛MVD治疗可获得满意效果。病程、年龄、责任血管类型和三叉神经痛分型是MVD术后远期疗效的主要影响因素。
Abstract:
Objective To explore the contributing factors of the long-term effectiveness of microvascular decompression(MVD) for classical trigeminal neuralgia(TN) to improve the efficacy of MVD. Methods The clinical data of 99 patients with TN who underwent MVD treatment from January 2014 to November 2019 in the Department of Neurosurgery, the Affiliated Brain Hospital of Nanjing Medical University were analyzed retrospectively. The postoperative efficacy was followed up through outpatient and telephone ask. A single factor analysis was used to analyze the relationship between each factor and the effectiveness, and relevant factors were screened out, then they were used in the Cox regression models to analyze the contributing factors of postoperative efficacy. Results Eighty-six were completely painless(BNI I) after surgery, and immediate remission rate was 86.9%. Kaplan-Meier survival analysis showed that the pain relief rates of TN patients at 1 year, 3 years, and 5 years were 86.7%, 73.9%, and 70.7%, respectively. Multivariate Cox regression analysis showed that age≥60 years(P=0.03), duration<5 years(P=0.011), arterial compression(vein& artery vs pure artery P=0.006, pure vein vs pure artery P=0.007)and typical TN(P=0.02)were independent predictors of good long-term outcomes. Conclusions Patients receiving MVD can obtain satisfactory results. The disease course, age, culprit vessels, and clinical presentation have certain effects on the long-term efficacy of MVD.

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更新日期/Last Update: 2020-06-17