摘要目的:评价全程神经内镜微血管减压术（MVD）治疗三叉神经痛（TN）术后复发的相关因素。方法:回顾性分析首都医科大学附属北京世纪坛医院神经外科2008年12月至2020年12月期间采用全程神经内镜MVD治疗112例TN患者临床基线资料和术前MRI影像学数据，包括：桥小脑区（CPA）面积比（健/患侧）、三叉神经（TGN）长度比（健/患侧）、TGN夹角比（健/患侧）、责任血管类型。采用多因素Cox比例风险模型分析影响术后复发的因素。结果:本组112例患者中，其中男49例，女63例；年龄20~82（59±9）岁，病程0.05~30.00（5.60±5.15）年。疼痛位于左侧43例（38.39%），右侧69例（61.61%）；所有患者随访时间均>1年，平均随访时间21.5个月，复发11例。多因素Cox比例风险模型显示，病程≥3年（ HR=9.34，95% CI：1.12~39.07）、CPA面积比（健/患侧）>1（ HR=27.47，95% CI：1.69~44.20）、责任血管类型为静脉（ HR=35.39，95% CI：1.26~18.60）以及动静脉（ HR=46.07，95% CI：2.74~27.75）是影响MVD术后复发的因素（均 P<0.05）。 结论:患者病程≥3年、CPA面积比（健/患侧）>1、责任血管类型为静脉/动静脉是影响全程神经内镜MVD治疗TN痛术后复发率的相关因素。

abstractsObjective:To evaluate the related factors of postoperative recurrence intrigeminal neuralgia (TN) patients treated with fully neuroendoscopic microvascular decompression (MVD).Methods:The clinical baseline data and preoperative MRI imaging data of 112 patients with TN treated by neuroendoscopic MVD from December 2008 to December 2020 in the Department of Neurosurgery, Beijing Shijitan Hospital Affiliated to Capital Medical University were retrospectively analyzed, including: area ratio of cerebellopontine area (CPA)(healthy side/affected side), trigeminal nerve(TGN)length ratio(healthy side/affected side), TGN angle ratio(healthy side/affected side), and criminal vessel type. Multivariate Cox proportional hazards model was used to analyze the factors affecting postoperative recurrence.Results:Among the 112 patients in this group, there were 49 males and 63 females. The age ranged from 20 to 82 (59±9) years, and the course of disease was 0.05 to 30.00 (5.60±5.15) years. Pain was located on the left side in 43 cases (38.39%) and on the right side in 69 cases (61.61%), respectively. All patients were followed up for more than 1 year, with an average follow-up time of 21.5 months, and 11 cases recurred. Multivariate Cox regression analysis revealed that disease duration≥3 years( HR=9.34, 95% CI:1.12-39.07), CPA area ratio(healthy side/affected side)>1 ( HR=27.47, 95% CI:1.69-44.20), criminal vessel type with vein( HR=35.39, 95% CI:1.26-18.60) and criminal vessel type with arteriovenous ( HR=46.07, 95% CI: 2.74-27.75) were the main factors influencing recurrence of MVD surgery (all P<0.05). Conclusion:The disease duration≥3 years, CPA area ratio(healthy side/affected side)>1, and criminal vessel type with vein/arteriovenous are the relevant factors that affect the recurrence rate after the fully neuroendoscopic MVD treatment for trigeminal neuralgia.