摘要
目的探讨经皮穿刺微球囊压迫术(PBC)治疗三叉神经痛术后发生面部单纯疱疹的危险因素。方法回顾性分析2019年4月至2020年8月在广西医科大学第二附属医院疼痛科诊断为三叉神经痛并接受PBC治疗的195例住院患者的临床资料。纳入标准:(1)根据2015年制定的《三叉神经痛诊疗中国专家共识》诊断为原发性三叉神经痛;(2)气管插管全身麻醉下行PBC治疗;(3)年龄≥18岁。排除标准:(1)继发性三叉神经痛;(2)病历记录不完整、出院后随访丢失。根据术后是否发生面部单纯疱疹分为疱疹组和非疱疹组,对两组患者年龄、性别、体质量指数(BMI)、ASA分级、病程、吸烟史、饮酒史、合并症、口服药物种类、术前数字等级评分(NRS评分)、患侧、累及神经分支、血液检验指标[白细胞总数、中性粒细胞绝对值、淋巴细胞绝对值、CD4^(+)和CD8^(+)计数、肿瘤坏死因子-α(TNF-α)以及白细胞介素-6(IL-6)]和手术操作时间、球囊持续压迫时间、注射造影剂容积、全麻机械通气时间、术后NRS评分多方面进行比较。采用单变量分析筛选出有统计学意义的变量,然后使用多变量logistic回归分析方法,探讨与PBC术后面部单纯疱疹发生的相关危险因素。结果181例患者最终完成研究,其中49例(27.1%)术后发生面部单纯疱疹,132例(72.9%)未发生单纯疱疹感染。多变量logistic回归分析显示年龄(OR=1.170,95%CI=1.064~1.287,P=0.001)、女性(OR=8.030,95%CI=1.461~44.150,P=0.017)、病程(OR=1.363,95%CI=1.188~1.465,P<0.001)、CD4^(+)计数下降(OR=0.879,95%CI=0.783~0.987,P=0.029)与发生面部单纯疱疹相关。结论年龄、女性、病程、CD4^(+)计数下降是PBC术后发生面部单纯疱疹的主要危险因素。
Objective To explore the risk factors of facial herpes simplex after percutaneous microballoon compression(PBC)in the treatment of patients with trigeminal neuralgia.Methods The clinical data of 195 inpatients with trigeminal neuralgia treated by PBC in the Pain Department,the Second Affiliated Hospital of Guangxi Medical University,from April 2019 to August 2020,were analyzed retrospectively.Inclusion criteria:(1)primary trigeminal neuralgia was diagnosed according to the"Chinese expert consensus on diagnosis and treatment of trigeminal neuralgia"in 2015;(2)general anesthesia with endotracheal intubation was performed;(3)age≥18 years old.Exclusion criteria:(1)secondary trigeminal neuralgia;(2)incomplete medical records and loss of follow-up after discharge.According to the occurrence of facial herpes simplex after the treatment,the patients were divided into herpes group and non-herpes group.Age,sex,body mass index(BMI),ASA grade,course of disease,smoking history,drinking history,concomitant diseases,types of oral drug,preoperative NRS,affected side,involved nerve branches,blood test indexes[total leukocyte count,absolute neutrophil value,lymphocyte absolute value,CD4^(+)and CD8^(+)count,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)]and operation time,balloon compression time,the volume of injection contrast medium,the time of mechanical ventilation during general anesthesia and NRS after the operation were collected and compared.Univariate analysis was used to screen out statistically significant variables and then multivariate logistic regression analysis was used to explore the risk factors associated with facial herpes simplex after PBC.Results There were 181 cases finished the study;49(27.1%)patients occurred facial herpes simplex Multivariate logistic regression analysis showed that age(OR=1.170,95%CI=1.064-1.287,P=0.001),female(OR=8.030,95%CI=1.461-44.150,P=0.017),course of disease(OR=1.363,95%CI=1.188-1.465,P<0.001)and CD4^(+)count(OR=0.879,95%CI=0.783-0.987,P=0.029)were closely related to th
作者
黄恒艺
张爱民
叶小龙
耿泽阳
吴逸伦
许圣荣
周增华
何睿林
蒋宗滨
Huang Hengyi;Zhang Aimin;Ye Xiaolong;Geng Zeyang;Wu Yilun;Xu Shengrong;Zhou Zenghua;He Ruilin;Jiang Zongbin(Department of Pain Management,the Second Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi Zhuang Autonomous Region 530007,China)
出处
《中华疼痛学杂志》
2021年第1期48-53,共6页
Chinese Journal Of Painology
基金
广西卫健委课题(Z20200369)
广西医科大学第二附属医院科研项目(EFYKY2020002)。
关键词
三叉神经痛
单纯疱疹
危险因素
球囊压迫
Trigeminal neuralgia
Herpes simplex
Risk factors
Balloon compression
