经皮穿刺球囊压迫术球囊压力与三叉神经痛疗效和并发症的相关性研究  

Correlation research between balloon pressure and both therapeutic effect and complications in patients with trigeminal neuralgia undergoing percutaneous balloon compression

作　　者：李春辉[1,2] 朱骁 陈涛 李欢[1,2] 罗刚 喻坚柏 梁昊[3] Li Chunhui;Zhu Xiao;Chen Tao;Li Huan;Luo Gang;Yu Jianbai;Liang Hao(Department of Neurosurgery,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410007,China;The First Clinical College of Chinese Medicine,Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410007,China;Chinese Medicine College,Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]湖南中医药大学第一附属医院神经外科,长沙410007 [2]湖南中医药大学第一中医临床学院,长沙410007 [3]湖南中医药大学中医学院,长沙410208

出　　处：《中国微侵袭神经外科杂志》2020年第11期489-492,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：湖南省卫生计生委科研资助项目(编号:20201190);湖南省自然科学基金(青年基金)(编号:2018JJ3404);中医药传承与创新“百千万”人才工程西学中骨干人才(编号:08-01-04)。

摘　　要：目的探讨经皮穿刺球囊压迫术(percutaneous balloon compression,PBC)治疗三叉神经痛过程中球囊压力与术后疼痛缓解、远期疗效、安全性的关系,并确定最佳的压力范围。方法回顾性分析47例PBC治疗原发性三叉神经痛病人的临床资料,术中检测球囊压力。分析术后治疗效果、并发症与球囊压力的相关性。结果本组术后即刻有效率97.9%,手术前后BNI(Barrow neurological institute,BNI)疼痛分级评分差异具有统计学意义(P<0.05)。球囊压力与术后麻木程度、复发均具有相关性(P<0.05),而与球囊充盈量不相关(P>0.05);球囊充盈量与术后麻木程度也无相关性(P>0.05)。经Cox多因素回归分析:球囊压力并非复发的独立影响因素(P>0.05)。按稳健评估法,球囊压力参考范围为0.13~0.20 MPa。结论PBC治疗三叉神经痛过程中,通过球囊压力检测可以明确实施的压力范围,有利于该手术规范化,有望提高手术效果,减少手术并发症。Objective To explore the relationship between balloon pressure value and postoperative pain relief,long-term efficacy and safety in the percutaneous balloon compression(PBC)for treating trigeminal neuralgia,and to determine the best pressure range.Methods Clinical data of 47 patients with primary trigeminal neuralgia undergoing PBC were analyzed retrospectively,and balloon pressure was detected during the operation.The correlations between balloon pressure and both therapeutic effect and complications were summarized after the operation.Results The immediate response rate was 97.9%,and there was significant difference in BNI score between before and after the operation(P<0.05).Balloon pressure was correlated with postoperative numbness degree and recurrence(P<0.05),while not correlated with balloon filling volume(P>0.05).There was no correlation between balloon filling volume and postoperative numbness degree(P>0.05).Cox regression analysis showed that balloon pressure was not an independent factor for recurrence(P>0.05).The reference range of balloon pressure was 0.13 to 0.20 MPa according to the robust evaluation method.Conclusions During the treatment of PBC in patients with trigeminal neuralgia,the pressure range can be determined through balloon pressure detection,which is conducive to the standardization of the operation,and is expected to improve the effect of the operation and reduce the complications.

关 键 词：三叉神经痛 经皮球囊压迫术 球囊压力 

分 类 号：R745.11[医药卫生—神经病学与精神病学]