临床外科杂志 ›› 2021, Vol. 29 ›› Issue (2): 136-139.doi: 10.3969/j.issn.1005-6483.2021.02.011

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三叉神经痛减压术后复发风险预测模型的建立与验证

  

  1. 湖南中医药大学第一附属医院神经外科  
  • 出版日期:2021-02-20 发布日期:2021-02-20

Establishment and verification of risk prediction model for recurrence after decompression of trigeminal neuralgia

  • Online:2021-02-20 Published:2021-02-20

摘要: 目的:建立与验证三叉神经痛减压术后复发风险预测模型的可靠性。方法:2016年6月~2018年12月收治的三叉神经痛病人260例,均行微血管减压术。根据病例前后顺序分为建模组(200例)和验证组(60例),根据术后疼痛复发情况分复发组和常规组。用多因素Logistic回归分析影响三叉神经痛减压术后复发的相关因素,建立出列线图预测模型并验证。结果:建模组病人中有9例病例脱落,35例术后出现复发为复发组,剩余156例为常规组,手术复发率为18.32%。复发组有拔牙史,无明确责任血管,血管类型中动静脉均有压迫、累及3根及以上血管和行二次减压术所占比例高于常规组(P<0.05)。多因素Logistic回归分析显示,无明确责任血管、动静脉均有压迫和累及3根及以上血管是影响三叉神经痛减压术后复发风险的独立危险因素。列线图预测三叉神经痛减压术后复发风险的Cindex为0.917(95%Cl 0.854~0.949)。结论:本研究构建的简易三叉神经痛减压术后复发风险预测模型能准确的预测三叉神经减压术后的复发情况,有助于早期调整治疗方案。

关键词: 三叉神经痛, 减压术, 复发, 风险预测模型

Abstract: Objective:To explore the establishment and verification of a risk prediction model for recurrence after trigeminal neuralgia decompression.Methods:260 cases of trigeminal neuralgia patients undergoing microvascular decompression in the Department of Neurosurgery of our hospital from June 2016 to December 2018 were analyzed.The model group(n=200) and the verification group(n=60) were divided according to the sequence of the cases,and the recurrence group and the routine group were divided according to the postoperative pain recurrence.Multivariate Logistic regression was used to analyze the related factors affecting postoperative recurrence of trigeminal neuralgia,and a prediction model was established and verified.Results:Among the patients in the modeling group,9 cases fell off,35 cases had postoperative recurrence as the recurrence group,and the remaining 156 cases were in the conventional group,with a surgical recurrence rate of 18.32%.The proportion of the recurrent group with a history of tooth extraction,no clearly responsible vessels,arteriovenous compression,3 or more vessels involved,and second decompression was higher than that of the conventional group(P<0.05).Multivariate Logistic regression analysis showed that undefined responsibility vessels(OR=3.320),arteriovenous compression(OR=5.932) and 3 or more vessels involved(OR=3.799) were independent risk factors affecting the risk of recurrence after decompression of trigeminal neuralgia.The cindex of the risk of recurrence after decompression of trigeminal neuralgia was 0.917(95%Cl 0.854~0.949).Conclusion:This study constructed a simple risk prediction model for recurrence after trigeminal neuralgia decompression,which can accurately predict the recurrence after trigeminal neuralgia decompression,and is helpful for early treatment adjustment.

Key words: trigeminal neuralgia, decompression, recurrence, risk prediction model

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