面肌痉挛患者显微血管减压术后复发危险因素分析  

Analysis of risk factors for recurrence in patients with hemifacial spasm after microvascular decompression

作　　者：李涵 南成睿 郭丽斯 赵宗茂[1] 刘力强[1] Li Han;Nan Chengrui;Guo Lisi;Zhao Zongmao;Liu Liqiang(Department of Neurosurgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经外科,石家庄050000

出　　处：《脑与神经疾病杂志》2024年第4期199-202,共4页Journal of Brain and Nervous Diseases

基　　金：河北省县级综合医院适宜卫生技术推广项目(P20200005)。

摘　　要：目的通过分析面肌痉挛(HFS)患者行显微血管减压术(MVD)后复发的相关因素,进一步建立HFS患者MVD术后预测模型。方法选取2015年1月至2021年12月于河北医科大学第二医院神经外科行MVD的HFS患者267例,将MVD后未复发的患者与复发的患者的临床资料进行比较,应用Logistic回归分析研究MVD后HFS复发的危险因素,通过R软件来绘制列线图、校准曲线和受试着工作特征(ROC)曲线图。结果本组患者中,复发的患者有58例,未复发的患者有209例,复发率为21.72%;年龄、异常肌反应(AMR)消失与否、责任血管数量、病程是影响HFS患者MVD术后复发的危险因素;回归分析显示≤55岁、异常肌反应未消失、责任血管2根及以上以及病程5年以上是HFS患者MVD术后复发的独立危险因素;列线图、校准曲线和ROC曲线显示评估HFS患者MVD术后复发风险预测模型具有良好的校准度和区分度。结论年龄≤55岁,病程≥5年,术中AMR未消失,责任血管2根及以上是HFS患者MVD术后复发的危险指标。Objective The establishment of a prediction model for patients with hemifacial spasm(HFS)after microvascular decompression(MVD)was achieved through an analysis of the associated parameters contributing to recurrence.Methods From January 2015 to December 2021,267 HFS patients who received MVD at Hebei Medical University's Second Hospital with comprehensive were studied retrospectively.Patients who did not relapse following MVD had their clinical data compared to those who did.R software was used to create nomograms,calibration curves,and ROC curves to investigate the risk variables of HFS recurrence after MVD.Results In this group,there were 58 patients with recurrence and 209 patients without recurrence,and the recurrence rate was 21.72%.Age,the disappearance of abnormal muscle reaction,the number of responsible blood vessels and the course of disease are the risk factors affecting the recurrence of HFS after MVD.Regression analysis showed that≤55 years old,abnormal muscle response did not disappear,two or more responsible vessels and a course of more than 5 years were independent risk factors for recurrence of HFS after MVD.The nomogram,calibration curve,and ROC curve demonstrate that the prediction model for assessing the risk of hemifacial spasm recurrence following MVD has good calibration and discrimination.Conclusion Age≤55 years,course of disease≥5 years,AMR not disappeared during operation,and 2 or more responsible vessels are risk indicators for recurrence of HFS patients after MVD.

关 键 词：面肌痉挛 显微血管减压术 危险因素 异常肌反应 

分 类 号：R745.12[医药卫生—神经病学与精神病学]