摘要
目的评价全程神经内镜微血管减压术(MVD)治疗三叉神经痛(TN)术后复发的相关因素。方法回顾性分析首都医科大学附属北京世纪坛医院神经外科2008年12月至2020年12月期间采用全程神经内镜MVD治疗112例TN患者临床基线资料和术前MRI影像学数据,包括:桥小脑区(CPA)面积比(健/患侧)、三叉神经(TGN)长度比(健/患侧)、TGN夹角比(健/患侧)、责任血管类型。采用多因素Cox比例风险模型分析影响术后复发的因素。结果本组112例患者中,其中男49例,女63例;年龄20~82(59±9)岁,病程0.05~30.00(5.60±5.15)年。疼痛位于左侧43例(38.39%),右侧69例(61.61%);所有患者随访时间均>1年,平均随访时间21.5个月,复发11例。多因素Cox比例风险模型显示,病程≥3年(HR=9.34,95%CI:1.12~39.07)、CPA面积比(健/患侧)>1(HR=27.47,95%CI:1.69~44.20)、责任血管类型为静脉(HR=35.39,95%CI:1.26~18.60)以及动静脉(HR=46.07,95%CI:2.74~27.75)是影响MVD术后复发的因素(均P<0.05)。结论患者病程≥3年、CPA面积比(健/患侧)>1、责任血管类型为静脉/动静脉是影响全程神经内镜MVD治疗TN痛术后复发率的相关因素。
Objective To evaluate the related factors of postoperative recurrence intrigeminal neuralgia(TN)patients treated with fully neuroendoscopic microvascular decompression(MVD).Methods The clinical baseline data and preoperative MRI imaging data of 112 patients with TN treated by neuroendoscopic MVD from December 2008 to December 2020 in the Department of Neurosurgery,Beijing Shijitan Hospital Affiliated to Capital Medical University were retrospectively analyzed,including:area ratio of cerebellopontine area(CPA)(healthy side/affected side),trigeminal nerve(TGN)length ratio(healthy side/affected side),TGN angle ratio(healthy side/affected side),and criminal vessel type.Multivariate Cox proportional hazards model was used to analyze the factors affecting postoperative recurrence.Results Among the 112 patients in this group,there were 49 males and 63 females.The age ranged from 20 to 82(59±9)years,and the course of disease was 0.05 to 30.00(5.60±5.15)years.Pain was located on the left side in 43 cases(38.39%)and on the right side in 69 cases(61.61%),respectively.All patients were followed up for more than 1 year,with an average follow-up time of 21.5 months,and 11 cases recurred.Multivariate Cox regression analysis revealed that disease duration≥3 years(HR=9.34,95%CI:1.12-39.07),CPA area ratio(healthy side/affected side)>1(HR=27.47,95%CI:1.69-44.20),criminal vessel type with vein(HR=35.39,95%CI:1.26-18.60)and criminal vessel type with arteriovenous(HR=46.07,95%CI:2.74-27.75)were the main factors influencing recurrence of MVD surgery(all P<0.05).Conclusion The disease duration≥3 years,CPA area ratio(healthy side/affected side)>1,and criminal vessel type with vein/arteriovenous are the relevant factors that affect the recurrence rate after the fully neuroendoscopic MVD treatment for trigeminal neuralgia.
作者
梁鑫
关峰
胡志强
李滨
李亚坤
景贝
黄辉
朱广通
毛贝贝
Liang Xin;Guan Feng;Hu Zhiqiang;Li Bin;Li Yakun;Jing Bei;Huang Hui;Zhu Guangtong;Mao Beibei(Department of Neurosurgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2022年第31期2465-2469,共5页
National Medical Journal of China
关键词
三叉神经痛
微血管减压术
神经内镜
CPA面积
复发
随访研究
Trigeminal neuralgia
Microvascular decompression
Neuroendoscopy
CPA area
Recurrence
Follow-up study
