经皮三叉神经半月节球囊压迫术治疗原发性三叉神经痛疗效的影响因素及预测模型构建

doi:10.19854/j.cnki.1008-2425.2025.06.0003

摘要/Abstract

摘要： 目的探讨经皮三叉神经半月节球囊压迫术(PBC)治疗原发性三叉神经痛(PTN)疗效的影响因素,并构建预测手术疗效的列线图模型。方法回顾性分析2018年5月至2023年4月在本院行PBC的203例PTN患者的资料,根据术后1年的疗效分成疗效良好组和疗效不佳组。收集两组患者基本信息、疾病相关资料及手术资料并进行比较,利用Logistic回归分析对PBC术后疗效的相关因素予以筛查。基于确定的预测指标构建相关模型,并应用ROC曲线下面积(AUC)和校准曲线对其预测效能予以验证。结果术后疗效良好161例,良好率为79.31%,疗效不佳42例,不佳率为20.69%。疗效良好组和疗效不佳组体重指数、合并糖尿病情况、球囊体积、压迫时间及球囊形态经比较,具有统计意义(P＜0.05)。体重指数≥24 kg/m²(OR=2.380,95%CI:1.377~4.112)、合并糖尿病(OR=3.206, 95%CI:1.316~7.806)、压迫时间＜1.5 min(OR=3.569, 95%CI:1.711~7.443)、球囊形态呈哑铃型或椭圆形(OR=4.315, 95%CI:2.169~8.585)为PBC术后疗效不佳的危险因素。内部验证显示, AUC为0.854(95%CI:0.771~0.936),校准曲线拟合较佳,拟合优度HL检验χ²=8.176, P=0.416。结论根据体重指数、合并糖尿病情况、术中压迫时间、球囊形态构建的列线图模型可对PTN患者PBC术后疗效予以良好预测。

关键词: 经皮三叉神经半月节球囊压迫术, 原发性三叉神经痛, 手术疗效, 预测模型

Abstract: Objective To explore the influencing factors of efficacy of percutaneous balloon compression(PBC) for primary trigeminal neuralgia(PTN),and to construct a column chart model for predicting surgical efficacy. Methods A retrospective analysis was conducted on the data of 203 PTN patients who underwent PBC in our hospital from May 2018 to April 2023.According to the one-year postoperative efficacy,they were separated into a good efficacy group and a poor efficacy group.The basic information,disease-related data,and surgical data of the two groups were collected and compared.Logistic regression was applied to analyze the relevant factors for screening the postoperative efficacy of PBC.Based on the determined predictive indicators,a model was constructed,and the area under the ROC curve(AUC) and calibration curve were applied to verify their predictive performance. Results 161 cases had good postoperative efficacy,with a good rate of 79.31%,and 42 cases had poor efficacy,with a poor rate of 20.69%.There were obvious differences in body mass index,diabetes,balloon volume,compression time,and balloon shape between good efficacy group and poor efficacy group(P<0.05).Body mass index ≥ 24 kg/m²(OR=2.380,95% CI:1.377~4.112),combined with diabetes(OR=3.206,95% CI:1.316~7.806),compression time< 1.5min(OR=3.569,95% CI:1.711~7.443),and dumbbell shaped or elliptical balloon shape(OR=4.315,95% CI:2.169~8.585) were risk factors for poor postoperative efficacy of PBC.Internal validation showed that the AUC was 0.854(95% CI:0.771~0.936),and the calibration curve fit was good,the goodness of fit HL test showed χ²=8.176,and P=0.416. Conclusion The column chart model based on body mass index,diabetes,compression time during operation,and balloon shape can effectively predict the postoperative efficacy of PBC in PTN patients.

Key words: Percutaneous balloon compression, Primary trigeminal neuralgia, Surgical efficacy, Predictive model

中图分类号:

R745⁺1

张钧, 宋国智, 常成, 晁艳艳, 乔磊. 经皮三叉神经半月节球囊压迫术治疗原发性三叉神经痛疗效的影响因素及预测模型构建[J]. 立体定向和功能性神经外科杂志, 2025, 38(6): 333-338.

Zhang Jun, Song Guozhi, Chang Cheng, Chao Yanyan, Qiao Lei. Influencing factors of percutaneous microballoon compression for primary trigeminal neuralgia and construction of predictive model[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2025, 38(6): 333-338.

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