摘要
目的 分析三叉神经痛患者行经皮穿刺微球囊压迫术效果及术后复发的影响因素.方法 回顾性选择2020年1月至2023年6月西安交通大学医学院附属红会医院收治的106例三叉神经痛患者作为研究对象.按照治疗方法不同分为观察组和对照组,各53例.观察组行经皮穿刺微球囊压迫术治疗,对照组行微血管减压术治疗.比较两组的手术时间、住院时间、临床总有效率、并发症发生及复发情况;对观察组患者予以随访12个月,记录术后复发情况,以有无复发分为复发组和非复发组.使用单因素分析和多因素Logistic回归分析观察组患者术后复发的影响因素.结果 观察组手术时间、住院时间分别为(30.24±7.42)min、(6.12±1.56)d,均短于对照组[(117.61±20.82)min、(12.55±3.07)d],差异均有统计学意义(P＜0.05).观察组的临床总有效率为94.34％,显著高于对照组(81.13％),差异有统计学意义(P＜0.05).观察组面部麻木、咬肌无力发生率分别为37.74％、16.98％,均高于对照组(5.66％、3.77％),差异均有统计学意义(P＜0.05);两组在唇周疱疹、心动过缓、脑膜炎、耳鸣和复视的发生率和复发率上比较,差异均无统计学意义(P＞0.05).复发组与非复发组在病程、高血压、术中球囊压迫时间和术后面部麻木程度上差异均有统计学意义(P＜0.05).经多因素Logistic回归分析,高血压、术中球囊压迫时间和术后面部麻木程度均是三叉神经痛患者行经皮穿刺微球囊压迫术后复发的独立影响因素(P＜0.05).结论 三叉神经痛患者行经皮穿刺微球囊压迫术效果显著,安全性尚可.高血压、术中球囊压迫时间和术后面部麻木程度均是患者术后复发的独立影响因素.
Abstract
Objective To analyze the effect of percutaneous microballoon compression in patients with trigeminal neuralgia and the influ-encing factors of postoperative recurrence.Methods A total of 106 patients with trigeminal neuralgia admitted to Honghui Hospital Affiliated to Xi an Jiaotong University School of Medicine from January 2020 to June 2023 were retrospectively selected as the study subjects.According to differ-ent treatment methods,they were divided into the observation group and the control group,53 cases in each group.The observation group was trea-ted with percutaneous microballoon compression,and the control group was treated with microvascular decompression.The operation time,hospi-talization time,clinical total effective rate,complications and recurrence of two groups were compared.The patients in the observation group were followed up for 12 months,and the postoperative recurrence was recorded.The patients were divided into the recurrence group and the non-recur-rence group according to whether there was recurrence.The influence factors of observation group of patients with postoperative recurrence were an-alyzed using the single factor and multi-factor Logistic regression analysis.Results The operation time and hospitalization time of the observation group were(30.24±7.42)min and(6.12±1.56)d,respectively,which were shorter than those of the control group[(117.61±20.82)min and(12.55±3.07)d],the differences were statistically significant(P＜0.05).The total clinical effective rate of the observation group was 94.34％,which was significantly higher than that of the control group(81.13％),and the difference was statistically significant(P＜0.05).The incidence of facial numbness and masseter weakness in the observation group were 37.74％and 16.98％,respectively,which were higher than those in the control group(5.66％,3.77％),and the differences were statistically significant(P＜0.05);there were no significant differ-ences in the incidence and recurrence rate of perioral herpes,bradycardia,meningitis,tinnitus and diplopia between the two groups(P＞0.05).In the two groups in the lip weeks herpes,bradycardia,meningitis,tinnitus and the incidence of diplopia and the recurrence rate,differences were not significant(P＞0.05).There were significant differences in the course of disease,hypertension,intraoperative balloon compression time and postoperative facial numbness between the recurrent group and the non-recurrent group(P＜0.05).After multiariable Logistic regression analy-sis,high blood pressure,intraoperative balloon compression time and postoperative facial numbness degree is trigeminal neuralgia patients who suf-fer puncture micro balloon compression independent impact factors for postoperative recurrence(P＜0.05).Conclusion Percutaneous micro-balloon compression is effective and safe for patients with trigeminal neuralgia.Hypertension,intraoperative balloon compression time,postopera-tive degree of facial numbness are independent influencing factors for postoperative recurrence.
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