虚弱预测较老的TN患者治疗微血管减压的更糟糕的疼痛结果
Collin B Kilgore1, Anita L Kalluri2, Sumil K Nair2
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
World neurosurgery
|October 11, 2023
概括
经过微血管减压 (MVD) 的三角神经疼痛 (TN) 的脆弱患者可能会经历更糟糕的长期疼痛结果. 这项研究强调了脆弱性是影响MVD疗效的关键因素.
科学领域:
- 神经外科 神经外科
- 疼痛医学 医学 疼痛医学
- 老年病的医生 老年病的医生
背景情况:
- 三神经疼痛 (TN) 是一种严重的口面疼痛疾病.
- 微血管减压 (MVD) 是一种手术治疗TN的方法.
- 之前的数据表明,MVD的脆弱患者的并发症增加,但长期疼痛结果仍然未知.
研究的目的:
- 为了研究患者虚弱和长期疼痛结果之间的关系,TN.MVD后TN.
- 为了确定脆弱性是否会影响MVD在治疗TN疼痛中的持续有效性.
主要方法:
- 对368名在2007年至2020年期间接受MVD的TN患者 (≥60岁) 的分析.
- 使用修改的5项脆弱指数 (mFI-5) 评估脆弱性;患者被分类为非脆弱 (mFI-5 <2) 或脆弱 (mFI-5 >1).
- 统计分析包括t测试,奇平方测试,多变量顺序回归和Cox比例危险分析.
主要成果:
- 9.8%的患者被归类为脆弱.
- 虚弱的患者年龄较大,BMI较高,并有更多的并发症.
- 虚弱的患者在最终随访时报告了显著更高的疼痛水平 (P=0.04).
- 脆弱性独立地预测了更糟糕的长期疼痛结果 (P=0.01).
结论:
- 为TN接受MVD的脆弱患者面临较高的风险,长期疼痛控制较差.
- 这些发现对于管理脆弱TN患者的临床医生至关重要,为MVD疗效做出治疗决策提供了信息.
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