伽玛刀治疗三叉神经痛显效、复发时间及安全性的生存分析

发布时间：2018-06-01 22:42

本文选题：伽玛刀 + 三叉神经痛　；参考：《国际神经病学神经外科学杂志》2017年03期

【摘要】：目的探讨影响伽玛刀治疗三叉神经痛患者预后及安全性的相关因素。方法收集行伽玛刀治疗三叉神经痛患者92例,随访并观察术后疼痛缓解显效、复发时间及不良反应,分析影响预后的因素。结果病程、靶点脑桥缘距离、手术史是影响三叉神经痛伽玛刀术后显效时间的独立风险因素(RR=0.505,95%CI 0.297~0.859,P=0.012;RR=0.556,95%CI 0.333~0.929,P=0.025;RR=5.127,95%CI 1.746~15.052,P=0.003)。手术史、病程与伽玛刀治疗三叉神经痛的复发时间相关(χ~2=5.628,p=0.018;χ~2=3.863,p=0.049)。COX生存分析显示手术史、病程不是影响三叉神经痛伽玛刀术后复发时间的独立风险因素(p=0.089;p=0.458)。靶点脑桥缘距离8mm组较≥8mm组的不良反应率高(χ~2=3.993,p=0.046)。结论病程3年、靶点脑桥缘距离较短、无手术史是影响患者术后显效时间的积极因素。靶点脑桥缘距离较短可能导致不良反应相对增多。
[Abstract]:Objective to investigate the factors related to the prognosis and safety of gamma knife treatment for trigeminal neuralgia. Methods 92 patients with trigeminal neuralgia were collected with gamma knife. Follow up and observe the effect of postoperative pain relief, recurrence time and adverse reaction, and analyze the factors that affect the prognosis. The course of the disease, the distance of the pontine margin, and the history of operation were three. Independent risk factors (RR=0.505,95%CI 0.297~0.859, P=0.012; RR=0.556,95%CI 0.333~0.929, P=0.025; RR=5.127,95%CI 1.746~15.052, P=0.003) after gamma knife surgery for forked neuralgia (RR=5.127,95%CI 1.746~15.052, P=0.003). The history of surgery, the course of disease and the recurrence time of trigeminal neuralgia treated with gamma knife (chi, ~2=5.628, p=0.018; chi, ~2=3.863,) survival analysis The history of surgery was not an independent risk factor affecting the recurrence time of trigeminal neuralgia after gamma knife surgery (p=0.089; p=0.458). The adverse reaction rate of the target point of the bridge margin 8mm group was higher than that of the group of 8mm (~2=3.993, p=0.046). Conclusion the course of the disease was 3 years, the distance between the target point of the pontine margin was shorter, and the absence of the operation history was a positive factor affecting the postoperative development time of the patients. The shorter distance from the pontine margin may lead to a relative increase in adverse reactions.
【作者单位】：郑州人民医院伽玛刀治疗中心;郑州人民医院神经内科;
【分类号】：R651.3

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