摘要
目的探讨影响微血管减压术治疗三叉神经痛手术疗效的相关因素。方法回顾性分析2009年1月—2016年1月河西学院附属张掖人民医院120例原发性三叉神经痛患者的病例资料,用χ^2检验行单因素分析评价患者术后疗效的影响因素。结果患者男性67例,术后有效65例(97.0%),女性53例,术后有效42例(97.6%)(χ^2=0.175,P=0.807),年龄>60岁者12例,有效10例(83.3%),年龄≤60岁者108例,有效102例(94.4%),(χ^2=0.187,P=0.665),左侧面部疼痛者35例,有效31例(88.5%),右侧面部疼痛者85例,有效81例(95.2)(χ^2=0.029,P=0.864),疼痛持续时间>1年者10例,有效7例(70.0%),疼痛持续时间≤1年110例,有效107例(97.2%),(χ^2=0.069,P=0.793),三叉神经受压部位位于脑干91例,有效88例(96.7%),三叉神经受压部位位于脑池段29例,有效26例(89.6%)(χ^2=0.267,P=0.605),这些一般因素对手术疗效无明显影响(P>0.05)。典型三叉神经痛97例,有效97例(100.0%),非典型三叉神经痛23例,有效21例(91.3%)(χ^2=4.034,P=0.02),术前MRTA检查有血管压迫者102例,有效100例(98.0%),术前MRTA检查无血管压迫者18例,有效17例(94.4%)(χ^2=5.029,P=0.03),术中有责任血管者98例,有效98例(100.0%),术中无责任血管22例,有效20例(90.9%)(χ^2=4.061,P=0.00),以上是影响患者术后临床疗效的主要因素(P<0.05)。结论微血管减压术对于典型三叉神经痛患者、术前MRTA及术中明确有责任血管压迫者疗效显著。
Objective To explore the related factors affecting the efficacy of microvascular decompression in the treatment of trigeminal neuralgia.Methods The clinical data of 120 patients with primary trigeminal neuralgia from Zhangye People's Hospital affiliated to Hexi University from January 2009 to January 2016 were retrospectively analyzed,and the influencing factors of postoperative curative effect were evaluated byχ^2=test.Results 67 patients were male,65 patients were effective after surgery(97.0%),53 were female patients,and 42 patients were effective after surgery(97.6%).(χ^2=0.175,P=0.807),and 12 patients were aged>60 years.10 cases were effective(83.3%),108 cases were aged≤60 years,102 cases were effective(94.4%)(χ^2=0.187,P=0.665),35 cases of left facial pain,and 31 cases were effective(88.5%),85 cases of right facial pain,81 cases effective(95.2%)(χ^2=0.029,P=0.864)pain duration>1 year,10 cases,7 cases(70.0%),there were 110 cases of pain≤1 year,and 107 cases were effective(97.2%)(χ^2=0.069,P=0.793).The trigeminal nerve compression site was located in the brain stem in 91 cases,and 88 cases(96.7%)were effective.Nerve compression sites were located in the cerebral cerebellum segment in 29 cases and effective in 26 cases(89.6%).(χ^2=0.267,P=0.605).These general factors had no significant effect on the efficacy of the operation(P>0.05).97 cases of typical trigeminal neuralgia,97 cases effective(100.0),23 cases of atypical trigeminal neuralgia,21 cases effective(91.3%)(χ^2=4.034,P=0.02),preoperative MRTA examination had 102 cases of vascular compression,100 cases were effective(98.0%),18 cases without vascular compression before MRTA examination,17 cases were effective(94.4%)(χ^2=5.029,P=0.03),responsibility during the operation 98 cases of blood vessels,98 cases of effective(100.0%),22 cases of non-responsible blood vessels during operation,20 cases of effective(90.9%)(χ^2=4.061,P=4.061),which affect the patient's postoperative clinical efficacy(P<0.05).Conclusion Microvascular decompression is effective for patients with typical trigeminal neuralgia,preoperative MRTA,and those who are clearly responsible for vascular compression during the operation.
作者
成振林
周勤仁
康东
蔺俭
王斌
CHENG Zhen-lin;ZHOU Qin-ren;KANG Dong;LIN Jian;WANG Bin(Department of Neurosurgery,Zhangye People's Hospital Affiliated to Hexi University,Zhangye,Gansu Province,734000 China)
出处
《中外医疗》
2020年第7期5-8,共4页
China & Foreign Medical Treatment
关键词
三叉神经痛
微血管减压术
影响因素
Trigeminal neuralgia
Microvascular decompression
Influencing factors
作者简介
成振林(1977-),男,甘肃张掖人,硕士,主治医师,研究方向:功能神外;通讯作者:王斌(1977-),男,甘肃张掖人,本科,副主任医师,研究方向:功能神经外科,E-mail:18919369688@189.cn。
