经皮穿刺微球囊压迫术治疗手术后复发性三叉神经痛及其负性情绪的疗效分析

Analysis of percutaneous microballoon compression on clinical efficacy and negative emotion for patients with postoperative recurrent trigeminal neuralgia

目的:探讨经皮穿刺微球囊压迫术(PMC)治疗手术后复发性三叉神经痛的疗效及对负性情绪的影响。方法:选择2017年8月至2019年1月在郑州大学第一附属医院行PMC治疗手术后复发性三叉神经痛患者89例,于术前(T0)、术后1 d(T1)、1个月(T2)、3个月(T3)、6个月(T4)和12个月(T5)记录巴罗神经病学研究所疼痛量表(BNI-P)评分,评估手术疗效及并发症情况;记录患者综合医院焦虑抑郁量表(HADS)评分及匹兹堡睡眠质量指数(PSQI)评分,评估患者的焦虑、抑郁和睡眠状态。结果:与T0时比较,患者在T1~T5时BNI-P评分、HADS评分及PSQI评分均明显降低(P<0.05),手术有效率分别为93.3%、95.5%、95.5%、94.4%和91.0%。本组患者有6例(6.7%)术后1 d疼痛未明显缓解,其中2例患者在术后2周时疼痛明显缓解;随访期间有4例(4.5%)疼痛复发。结论:PMC具有疼痛缓解率高、复发率低等优点,且可明显改善TN所引起的负性情绪,可能是治疗术后复发性三叉神经痛的最佳选择,值得临床推广应用。

Aim:To investigate the efficacy of percutaneous microballoon compression(PMC)in the treatment of patients with postoperative recurrent trigeminal neuralgia(TN)and analyze the effects of PMC on the negative emotions of the patients.Methods:A total of 89 patients with postoperative recurrent TN were treated with PMC in our hospital from August 2017 to January 2019.The Barrow Neurological Institute pain intensity(BNI-P)score was recorded preoperatively(T0)and 1 day(T1),1 month(T2),3 months(T3),6 months(T4),and 12 months(T5)postoperatively,which was used to measure clinical efficacy and its complications.The hospital anxiety and depression scale(HADS)and pittsburgh sleep quality index(PSQI)were recorded at the same time points and used to evaluate anxiety,depression and sleep status.Results:Compared with T0,the BNI-P,HADS and PSQI scores significantly decreased at T1-T5(P<0.05).The efficacies at the different time points were 93.3%,95.5%,95.5%,94.4%,and 91.0%.In this study,6 patients(6.7%)had no significant pain relief 1 day postoperatively,of whom 2 patients had significant pain relief 2 weeks postoperatively.In addition,4 patients(4.5%)had recurrent pain during the follow-up period.Conclusion:PMC has unique advantages,such as high pain relief rate and low recurrence rate.Moreover,it significantly improves negative emotion caused by TN,so it appears to be regarded as an optimized choice for patients with recurrent TN after surgical procedures.