目的探索伽玛刀治疗三叉神经痛后复发的原因,以便提高手术疗效。方法回顾性分析随访285例中有26例伽玛刀治疗后疼痛复发病人,分析与年龄、性别、发病时间、是否辅助用药、靶点数、照射部位等13种因素的关系,两组或多组间计数资料的比较用Chi-square检验,Pearson法计算t值,P<0.05为有统计学意义,以寿命表法统计复发率及中位复发时间,并用Cox回归模型(center法)多因素分析,使用SPSS for Windows11.0统计软件。结果三叉神经痛的复发率为9.12%,与年龄、性别、单双侧均发病、是否有手术史、等因素不存在统计学差异(P<0.05标准),临床分型、照射部位、三叉神经根部显示清晰度、靶点数目等因素与复发组存在统计学差异(P<0.05标准)。结论三叉神经痛患者经伽玛刀治疗后的复发率为9.12%,复发中位时间为44.7个月,三叉神经痛的复发与使用的靶点数、疼痛的三叉神经支数、照射部位、三叉神经根部显示清晰度等因素有关。为了提高疗效,降低复发率,应使用双靶点、高场强磁共振,照射部位选择三叉神经根部近脑桥端(REZ)。 Objective To explore the reason of gamma knife recurrence after trigeminal neuralgia in order to improve the surgical effect. Methods A retrospective analysis of 285 follow-up in 26 patients with recurrent pain after gamma knife treatment, analysis of age, gender, onset time, whether the adjuvant medication, target number, irradiation sites and other 13 factors, two or more groups Chi-square test and Pearson’s method were used to compare the count data between two groups. P <0.05 was considered statistically significant. The recurrence rate and median time to recurrence were calculated by life table method. Cox regression model (center method) multivariate analysis , Using SPSS for Windows11.0 statistical software. Results The recurrence rate of trigeminal neuralgia was 9.12%. There were no significant differences between the two groups (P <0.05) in terms of age, gender, single or bilateral disease, surgical history and other factors (P <0.05) Root clarity, the number of targets and other factors and recurrence group there was a statistically significant difference (P <0.05 standard). Conclusion The recurrence rate of patients with trigeminal neuralgia after gamma knife treatment was 9.12%, the median time to recurrence was 44.7 months, the number of targets of recurrence and use of trigeminal neuralgia, the number of trigeminal nerve pain, irradiation site, trigeminal nerve Root display clarity and other factors. In order to improve the curative effect and reduce the relapse rate, we should use double targets and high field MRI to select REZ.