经皮穿刺微球囊压迫术治疗原发性三叉神经痛并发症的危险因素分析
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摘要
目的探讨经皮穿刺微球囊压迫术治疗原发性三叉神经痛术后并发症的影响因素。方法回顾性分析2015年12月至2017年6月经皮穿刺微球囊压迫术治疗的428例原发性三叉神经痛的临床资料。采用多因素Logistic回归分析术后并发症的危险因素。结果 428例中,术后发生并发症383例。多因素Logistic回归分析显示病程≥5年、疼痛累及三叉神经第二支、合并高血压、合并糖尿病是术后并发症的独立危险因素(P<0.05)。结论经皮穿刺微球囊压迫术原发性三叉神经痛的术后并发症发生率高,控制血压、血糖水平,并适当调整术中球囊参数,有助于减少术后并发症。
Objective To explore the factors related to the complication after the percutaneous microballoon compression in the patients with primary trigeminal neuralgia(PTN). Methods The clinical data of 428 patients with PTN undergoing percutaneous microballoon compression from December, 2011 to December 2017 were analyzed retrospectively. The factors related to the postoperative complications were statistically analyzed by multivariate Logistic regression analysis. Results Of 428 patients with PTN,383 had postoperative complication and 45 did not. The multivariate Logistic regression analysis showed that the course of disease ≥5 years, pain involving the second branch of trigeminal nerve and associated hypertension and diabetes mellitus were the independent risk factors of the complications after the percutaneous microballoon compression in the patients with PNT(P<0.05). Conclusions The course of disease, pain involving the second branch of trigeminal nerve, hypertension and diabetes mellitus are the factors related to complications occurrence after the percutaneous microballoon compression in the patients with PTN. It is suggested that the blood pressure and blood sugar levels should be controlled during perioperative period and balloon parameters should be adjusted in order to improve the prognoses in the patients with PTN.
Objective To explore the factors related to the complication after the percutaneous microballoon compression in the patients with primary trigeminal neuralgia(PTN). Methods The clinical data of 428 patients with PTN undergoing percutaneous microballoon compression from December, 2011 to December 2017 were analyzed retrospectively. The factors related to the postoperative complications were statistically analyzed by multivariate Logistic regression analysis. Results Of 428 patients with PTN,383 had postoperative complication and 45 did not. The multivariate Logistic regression analysis showed that the course of disease ≥5 years, pain involving the second branch of trigeminal nerve and associated hypertension and diabetes mellitus were the independent risk factors of the complications after the percutaneous microballoon compression in the patients with PNT(P<0.05). Conclusions The course of disease, pain involving the second branch of trigeminal nerve, hypertension and diabetes mellitus are the factors related to complications occurrence after the percutaneous microballoon compression in the patients with PTN. It is suggested that the blood pressure and blood sugar levels should be controlled during perioperative period and balloon parameters should be adjusted in order to improve the prognoses in the patients with PTN.
引文
[1]郭韧,张路.手法整复寰枢关节旋转性半脱位治疗三叉神经痛4例报告[J].世界中医药,2014,9:1048-1050.
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[10]李在雨,罗毅男,陈云鹏,等.三叉神经痛微球囊压迫术相关并发症的影响因素分析[J].中华神经外科疾病研究杂志,2016,15(2):169-170.
[11]Desouza DD,Moayedi M,Chen DQ,et al.Sensorimotor and pain modulation brain abnormalities in trigeminal neuralgia:a paroxysmal,sensory-triggered neuropathic pain[J].Plos One,2013,8(6):e66340-e66340.
[12]鲍龙,李想,衣服新.微血管减压术(MVD)与微球囊压迫术(PMC)治疗原发性三叉神经痛的疗效比较[J].辽宁医学院学报,2016,37(4):85-87.
[13]杜垣锋,杨定博,俞文华.经皮穿刺球囊压迫半月节治疗微血管减压术后复发性三叉神经痛[J].医学研究杂志,2014,43(8):118-120.
[14]俞文华.影响经皮穿刺球囊压迫术治疗三叉神经痛疗效的因素[J].实用医学杂志,2014,30(21):3379-3380.
[15]应翔,陈景南,陈可安.经皮穿刺微球囊压迫三叉神经半月节治疗三叉神经痛进展[J].浙江临床医学,2017,19(9):1751-1753.
[2]杜灵霞.不同入路射频术治疗原发性三叉神经痛的效果分析[J].贵州医药,2017,12(6):642-644.158154
[3]曹莹,李宁怡,任益民.半月神经节射频热凝对复发型三叉神经痛的疗效[J].贵州医科大学学报,2015,40(10):1087-1089.
[4]康鹏,王双义,肖文林,等.三叉神经痛的诊断和治疗进展[J].中华临床医师杂志(电子版),2013,12(24):11816-11820.
[5]潘绵顺,李勇,邱书珺.三叉神经痛的发病机制及立体定向放射外科治疗进展[J].世界复合医学,2015,1(2):144-148.
[6]Chen G,Wang X,Wang L,et al.Arterial compression of nerve is the primary cause of trigeminal neuralgia[J].Neurol Sci,2014,35(1):61-66.
[7]王长明,关占颖,蔡长华.经皮微球囊压迫三叉神经半月节治疗三叉神经痛的研究进展[J].中国疼痛医学杂志,2015,21(4):297-300.
[8]Zhang H,Lei D,You C,et al.The long-term outcome predictors of pure microvascular decompression for primary trigeminal neuralgia[J].World Neurosurg,2013,79(5-6):756-762.
[9]应翔,沈煜豪,王昊,等.经皮穿刺微球囊压迫术治疗80岁以上老年病人三叉神经痛的疗效分析[J].中国疼痛医学杂志,2018,7(2):107-111.
[10]李在雨,罗毅男,陈云鹏,等.三叉神经痛微球囊压迫术相关并发症的影响因素分析[J].中华神经外科疾病研究杂志,2016,15(2):169-170.
[11]Desouza DD,Moayedi M,Chen DQ,et al.Sensorimotor and pain modulation brain abnormalities in trigeminal neuralgia:a paroxysmal,sensory-triggered neuropathic pain[J].Plos One,2013,8(6):e66340-e66340.
[12]鲍龙,李想,衣服新.微血管减压术(MVD)与微球囊压迫术(PMC)治疗原发性三叉神经痛的疗效比较[J].辽宁医学院学报,2016,37(4):85-87.
[13]杜垣锋,杨定博,俞文华.经皮穿刺球囊压迫半月节治疗微血管减压术后复发性三叉神经痛[J].医学研究杂志,2014,43(8):118-120.
[14]俞文华.影响经皮穿刺球囊压迫术治疗三叉神经痛疗效的因素[J].实用医学杂志,2014,30(21):3379-3380.
[15]应翔,陈景南,陈可安.经皮穿刺微球囊压迫三叉神经半月节治疗三叉神经痛进展[J].浙江临床医学,2017,19(9):1751-1753.