三叉神经痛显微血管减压术术后复发的影响因素分析

Risk factors of recurrence after microvascular decompression for trigeminal neuralgia

目的探讨影响三叉神经痛(TN)显微血管减压术(MVD)术后复发的相关危险因素。方法选取济宁市第一人民医院神经外科自2012年1月至2014年12月收治的400例符合原发性TN诊断标准并经MVD治疗的患者,将患者分为复发组(36例)和未复发组(364例)。比较2组患者的临床资料,多因素Logistic回归分析TN患者MVD术后复发的危险因素。结果术后2年内复发36例。女性复发率(9.4%)高于男性(8.0%),无血管压迫组复发率(40.0%)高于有血管压迫组(8.6%),各疼痛分支组内复发率由高至低分别为V_(2-3)(13.4%)、V_2(12.5%)、V_1(9.1%)、V_3(7.5%)、V_(1-2-3)(4.4%)、V_(1-2)(4.3%)、V_(1-3)(0.0%),差异有统计学意义(P<0.05)。多因素Logistic回归分析显示性别、血管压迫、疼痛分支是影响患者术后复发的危险因素,且女性、V_(2-3)、V_2、V_3、无血管压迫的患者MVD术后复发率高。结论患者的性别、有无血管压迫、疼痛分支是单纯MVD治疗原发性TN术后复发的主要影响因素。

Objective To explore the risk factors of recurrence of trigeminal neuralgia(TN)after microvascular decompression(MVD).Methods Four hundred patients with primary TN were treated with MVD from January 2012 to December 2014 in the Department of Neurosurgery of Jining First People’s Hospital were selected and divided into recurrence group(36 cases)and non-recurrence group(364 cases).Multivariate logistic regression was used to analyze the risk factors of MVD recurrence in TN patients.Results Thirty-six patients recurred within 2 years after operation.The recurrence rate in females(9.4%)was higher than that in males(8.0%).The recurrence rate in non-vascular compression group(40.0%)was higher than that in vascular compression group(8.6%).The recurrence rates in pain branches were V2-3(13.4%),V2(12.5%),V1(9.1%),V3(7.5%),V1-2-3(4.4%),V1-2(4.3%)and V1-3(0.0%)respectively.The difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that gender,vascular compression and pain branches were risk factors for postoperative recurrence.The recurrence rate of MVD in female,V2-3、V2、V3 and non-vascular compression patients was high.Conclusion Sex,vascular compression and pain branches were the main factors affecting recurrence of primary TN after MVD alone.