在患有三角神经疼痛的患者微血管减压后诊断的抑郁症对术后结果的影响
Anita L Kalluri1, Emeka Ejimogu1, Sai Chandan Reddy1
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Clinical neurology and neurosurgery
|February 22, 2025
概括
患有三角神经疼痛 (TN) 和抑郁症的患者在微血管减压 (MVD) 后经历了更糟糕的结果. 抑郁症诊断与术后疼痛增加和复发率增加有关,突出显示了手术前查的必要性.
科学领域:
- 神经外科 神经外科
- 精神病学是一个精神病学.
- 疼痛医学 医学 疼痛医学
背景情况:
- 三神经疼痛 (TN) 经常伴有抑郁症,但其对外科手术结果的影响尚不清楚.
- 微血管减压 (MVD) 是TN的主要治疗方法.
研究的目的:
- 调查经过MVD的TN患者诊断的抑郁病史和术后结果之间的关联.
主要方法:
- 在2007年至2023年期间接受MVD的1007名TN患者的回顾性审查.
- 在患有抑郁症和没有抑郁症的患者之间比较人口统计学,临床和疼痛结果 (修改巴罗神经研究所得分).
- 使用多变量回归,卡普兰-梅尔和考克斯比例危险模型进行统计分析.
主要成果:
- 18%的患者被诊断患有抑郁症,通常是2型TN的年轻女性.
- 抑郁症独立地与手术后疼痛增加有关 (p=0.009).
- 患有抑郁症的患者疼痛无复发间隔较短 (p=0.0063) 和复发风险更高 (p=0.048).
结论:
- 在接受MVD的TN患者中,先前存在的抑郁症与较差的疼痛控制和增加复发风险相关.
- 这些发现强调了TN中抑郁症的高患病率及其可能对外科手术结果产生负面影响.
- 术前精神病学查和量身定制的管理对于优化TN抑郁症患者的MVD结果至关重要.
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