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目的 观察三叉神经痛(TN)患者实施显微血管减压术治疗的近期及远期疗效.方法 回顾性分析2008年12月至2011年11月应用显微血管减压术进行治疗的108例TN患者的临床资料,观察患者术后2年内疼痛的改善情况,同时结合年龄与病程,以及压迫血管的类型,是否出现明显压迫切迹等情况,对TN的复发因素予以分析.结果 术中发现全部患者均存在血管压迫,其中93例出现明显压迫切迹,包括存在动脉性压迫85例,静脉性压迫15例,动静脉联合压迫8例,其中动脉性压迫患者中有74例存在明显压迫切迹,而静脉性压迫中有11例出现明显压迫切迹,8例动静脉联合压迫均能够见到明显的压迫切迹.术后1周,患者动脉性压迫均获得明显改善,其中79例被判定为优,6例被判定为良;静脉性压迫患者9例效果达到优,6例达到良;而动静脉联合压迫患者5例效果达到优,3例达到良.在术后1年的随访中,5例动脉性压迫出现复发,其中3例为部分复发,2例为完全复发;6例静脉性压迫出现复发;2例动静脉联合压迫患者均出现完全复发.单因素分析结果显示,血管压迫类型、血管压迫切迹、病程为影响术后复发的危险因素(P＜0.01).多因素回归分析结果显示,血管压迫类型、血管压迫程度、病程为影响术后复发的独立危险因素(P＜0.05).结论 TN患者应用显微血管减压术进行治疗,效果确切,其中病程、血管压迫类型以及压迫程度是影响患者术后出现复发比较重要的因素.“,”Objective To observe the short-term and long-term effect of microvascular decompression in patients with trigeminal neuralgia (TN).Methods The chnical data of 180 patients with TN treated with microvascular decompression were retrospectively analyzed.The pain improvement of patients in 2 years was observed,combined with age and course of disease,as well as the type of pressure vessels,whether obvious impression and so on,to analysis the recurrence factors of TN.Results All patients were found with vascular compression,including 93 cases with apparent pressure pressing mark,85 cases with arterial compression,15 cases with venous compression,and 8 cases with arteriovenous compression,among of them 74 patients with artery compression had pressure pressing mark,and 11 patients with vascular compression had pressure pressing mark,all of 8 patients with arteriovenous compression had pressure pressing mark.One week postoperatively,the patients with vascular compression gained significant improvement,of which 79 cases achieved optimal,6 cases achieved good;9 patients with vascular compression achieved optimal,6 cases achieved good,and 5 patients with arteriovenous compression achieved optimal,3 cases achieved good.Follow-up for 1 year after surgery,artery compression recurred in 5 cases,of which 3 cases of part recurrence,2 cases of recurrence completely ;vascular compression recurred in 6 cases;arteriovenous compression recurred in 2 cases.Univariate analysis showed that the vascular compression type,bascular compression notch and duration were the risk factors of postoperative recurrence (P ＜ 0.01).Multiple analysis showed that the vascular compression type,bascular compression degree and duration were the independent risk factors of postoperative recurrence (P ＜ 0.05).Conclusions TN patients treatd with microvascular decompression have effective improvement.History of diease,vascular compression type and compression degree are the important influence factors of postoperative recurrence.