个体因素对经皮穿刺球囊压迫术治疗原发性三叉神经痛疗效的影响

doi:10.3969/j.issn.1006-6233.2023.07.016

Abstract
Figure/Table
References
Related Citation (0)

Download: PDF (1996 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To explore the influence of individual factors on the efficacy of percutaneous balloon compression in the treatment of primary trigeminal neuralgia. Methods: The clinical data of 89 PTN patients treated with PBC from November 2018 to February 2022 were analyzed retrospectively. The pain score of Barrow Neurological Institute was used to grade facial pain. The pain recurrence (BNI pain score) was followed up and recorded at 3, 6, 9 and 12 months after surgery, and patients were divided into the cure group (BNI pain score Ⅰ to Ⅱ) and recurrence group (BNI pain score Ⅲ to Ⅴ) based on the results of the follow-up at month 12, and the gender, age, body mass index (BMI), underlying disease (hypertensive disease) were analyzed between the two groups of patients, diabetes mellitus), side, disease duration, involved branches, surgical history, preoperative BNI pain score, size of the external orifice of the foramen ovale (FO) (including longitudinal diameter, transverse diameter, longitudinal diameter ratio, and transverse diameter ratio), and other individual factors and recurrence after PBC were analyzed between the two groups. Results: During the follow-up period, 18 patients experienced pain recurrence. Univariate analysis showed that there was no significant difference in sex, age, hypertension, diabetes, side, involved branches, preoperative BNI pain score, transverse diameter and transverse diameter ratio of FO between the cure group and the relapse group (P>0.05); BMI, disease duration, operation history, length to diameter and length to diameter ratio of FO were related to the postoperative effect (P<0.05). Multivariate logistic regression analysis of significant individual factors showed that BMI≥24kg/m², disease duration≥5 years, and previous surgical history were independent risk factors for postoperative pain recurrence (P<0.05), and FO length was a protective factor for postoperative recurrence (P<0.05). ROC curve analysis showed that FO length had a predictive effect on pain recurrence after PBC (P<0.05), with a predictive effect of 68.9%. The calculated maximum Joden index is 0.359, the corresponding FO length diameter is 6.74mm, the sensitivity is 0.803, and the specificity is 0.556. Conclusion: PBC is an effective surgical treatment for PTN, and individual factors have an important impact on the recurrence of pain after PBC.

Key words： Primary trigeminal neuralgia Percutaneous balloon compression Individual factors

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.07.016 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I7/1142

[1] 周霞,孙中武.三叉神经痛的发病机制及治疗进展[J].中华全科医学,2019,17(6):891-892.
[2] Lee CH,Jang HY,Won HS,et al.Epidemiology of trigeminal neuralgia:an electronic population health data study in Korea[J].Korean Pain,2021,34(3):332-338.
[3] Chaves JPG,DE Oliveira TVHF,Francisco AN,et al.Trigeminal neuralgia recurrence:a comparison of microvascular decompression and percutaneous balloon compression:a five years follow-up study[J].Arq Neuropsiquiatr,2021,79(1):51-55.
[4] 中华医学会神经外科学分会功能神经外科学组,中国医师协会神经外科医师,分会功能神经外科专家委员会,上海交通大学颅神经疾病诊治中心.三叉神经痛诊疗中国专家共识[J].中华外科杂志,2015,53(9):657-664.
[5] Rehman A,Abbas I,Alamgir,et al.Association between trigeminal neuralgia and unnecessary tooth extraction[J].Ayub Med Coll Abbottabad,2021,33(1):116-119.
[6] Fan X,Xu F,Ren H,et al.The analysis of percutaneous balloon compression on eficacy and negative emotion in the treatment of recurrent trigeminal neuralgia after surgical procedures[J].Pain Physician,2021,24(8):1255-1262.
[7] Araya EI,Claudino RF,Piovesan EJ,et al.Trigeminal neuralgia:basic and clinical aspects[J].Curr Neuropharmacol,2020,18(2):109-119.
[8] Jones MR,Urits I,Ehrhardt KP,et al.A comprehensive review of trigeminal neuralgia[J].Curr Pain Headache Rep,2019,23(10):74.
[9] Bick SKB,Eskandar EN.Surgical treatment of trigeminal neuralgia[J].Neurosurg Clin N Am,2017,28(3):429-438.
[10] Xia Y,Yu G,Min F,et al.The focus and new progress of percutaneous balloon compression for the treatment of trigeminal neuralgia[J].Pain Res,2022,29(15):3059-3068.
[11] 李春辉,朱骁,陈涛,等.经皮穿刺球囊压迫术球囊压力与三叉神经痛疗效和并发症的相关性研究[J].中国微侵袭神经外科杂志,2020,25(11):489-492.
[12] Montano N,Papacci F,Cioni B,et al.The role of percutaneous balloon compression in the treatment of trigeminal neuralgia recurring after other surgical procedures[J].Acta Neurol Belg,2014,114(1):59-64.
[13] Ouchi N,Parker JL,Lugus JJ,et al.Adipokines in inflammation and metabolic disease[J].Nat Rev Immunol,2011,11(2):85-97.
[14] Dandona P,Weinstock R,Thusu K,et al.Tumor necrosis factor-alpha in sera of obese patients:fall with weight loss[J].Clin Endocrinol Metab,1998,83(8):2907-2910.
[15] Arranz LI,Rafecas M,Alegre C.Effects of obesity on function and quality of life in chronic pain conditions[J].Curr Rheumatol Rep,2014,16(1):390.
[16] Rossi HL,Luu AK,DeVilbiss JL,et al.Obesity increases nociceptive activation of the trigeminal system[J].Eur Pain,2013,17(5):649-653.
[17] 赵亚琴,谢可越.三叉神经V3支术后疼痛复发的危险因素[J].临床麻醉学杂志,2022,38(7):707-711.
[18] Zdilla MJ,Fijalkowski KM.The shape of the foramen ovale:a visualization aid for cannulation procedures[J].Craniofac Surg,2017,28(2):548-551.
[19] 褚丹涛,陈雅静,黄冰,等.卵圆孔最大横径及卵圆孔与棘孔距离的CT影像测量及其在三叉神经痛治疗中的应用[J].中华解剖与临床杂志,2019,(1):52-57.
[20] Wang Q,Chen C,Guo G,et al.A prospective study to examine the association of the foramen ovale size with intraluminal pressure of pear-shaped balloon in percutaneous balloon compression for trigeminal neuralgia[J].Pain Ther,2021,10(2):1439-1450.