个体因素对经皮穿刺球囊压迫术治疗原发性三叉神经痛疗效的影响  

Influence of Individual Factors on the Efficacy of Percutaneous Balloon Compression in the Treatment of Primary Trigeminal Neuralgia

作　　者：李传胜 王昆鹏[1] 杨婕[1] 韩凤伟[1] 呼铁民[1] 张继伟[1] 刘兵 闫丽娜[1] 刘文霞 LI Chuansheng;WANG Kunpeng;YANG Jie(The Affiliated Hospital of Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《河北医学》2023年第7期1142-1149,共8页Hebei Medicine

基　　金：2021年度河北省医学科学研究课题计划,(编号:20210969)。

摘　　要：目的:探讨个体因素对经皮穿刺球囊压迫术(Percutaneous Balloon Compression,PBC)治疗原发性三叉神经痛(Primary Trigeminal Neuralgia,PTN)疗效的影响。方法:对2018年11月至2022年2月经PBC治疗的89例PTN患者的临床资料进行回顾性分析,运用巴罗神经学研究所疼痛评分(Barrow Neurological Institute pain score,BNI疼痛评分)对面部疼痛进行分级。随访并记录术后3、6、9及12个月疼痛复发情况(BNI疼痛评分),根据第12个月的随访结果将患者分为治愈组(BNI疼痛评分Ⅰ~Ⅱ)和复发组(BNI疼痛评分Ⅲ~Ⅴ),分析两组患者之间性别、年龄、体重指数(Body Mass Index,BMI)、基础疾病(高血压病、糖尿病)、侧别、病程、累及分支、手术史、术前BNI疼痛评分、卵圆孔(Foramen Ovale,FO)外口大小(包括长径、横径、长径比、横径比)等个体因素与PBC术后复发之间的联系。结果:术后随访期间共有18例患者出现疼痛复发,单因素分析得出性别、年龄、高血压病、糖尿病、侧别、累及分支、术前BNI疼痛评分、FO的横径和横径比在治愈组和复发组中无显著差异(P>0.05);BMI、病程、手术史、FO的长径、长径比与术后疗效有关(P<0.05)。对有意义的个体因素进行多因素Logistic回归分析,结果示:BMI≥24kg/m^(2)、病程≥5年、既往手术史是术后疼痛复发的独立危险因素(P<0.05),FO长径是术后复发的保护性因素(P<0.05)。对FO长径行ROC曲线分析,结果示:FO长径对PBC术后疼痛复发具有预测作用(P<0.05),预测效力为68.9%。计算最大约登指数为0.359,其所对应FO长径为6.74mm,敏感度为0.803,特异性为0.556。结论:PBC是治疗PTN有效的外科手段,个体因素对PBC术后疼痛复发有重要影响。Objective:To explore the influence of individual factors on the efficacy of percutaneous balloon compression in the treatment of primary trigeminal neuralgia.Methods:The clinical data of 89 PTN patients treated with PBC from November 2018 to February 2022 were analyzed retrospectively.The pain score of Barrow Neurological Institute was used to grade facial pain.The pain recurrence(BNI pain score)was followed up and recorded at 3,6,9 and 12 months after surgery,and patients were divided into the cure group(BNI pain scoreⅠtoⅡ)and recurrence group(BNI pain scoreⅢtoⅤ)based on the results of the follow-up at month 12,and the gender,age,body mass index(BMI),underlying disease(hypertensive disease)were analyzed between the two groups of patients,diabetes mellitus),side,disease duration,involved branches,surgical history,preoperative BNI pain score,size of the external orifice of the foramen ovale(FO)(including longitudinal diameter,transverse diameter,longitudinal diameter ratio,and transverse diameter ratio),and other individual factors and recurrence after PBC were analyzed between the two groups.Results:During the follow-up period,18 patients experienced pain recurrence.Univariate analysis showed that there was no significant difference in sex,age,hypertension,diabetes,side,involved branches,preoperative BNI pain score,transverse diameter and transverse diameter ratio of FO between the cure group and the relapse group(P>0.05);BMI,disease duration,operation history,length to diameter and length to diameter ratio of FO were related to the postoperative effect(P<0.05).Multivariate logistic regression analysis of significant individual factors showed that BMI≥24kg/m^(2),disease duration≥5 years,and previous surgical history were independent risk factors for postoperative pain recurrence(P<0.05),and FO length was a protective factor for postoperative recurrence(P<0.05).ROC curve analysis showed that FO length had a predictive effect on pain recurrence after PBC(P<0.05),with a predictive effect of 68.9%.The cal

关 键 词：经皮穿刺球囊压迫术 原发性三叉神经痛 个体因素 

分 类 号：R651.3[医药卫生—外科学]