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疼痛与心理困扰:微血管减压术对三叉神经痛患者睡眠障碍及强迫观念的影响

Pain and Psychological Distress: Effect of Microvascular Decompression on Sleep Disorders and Obsessions in Trigeminal Neuralgia.

作者信息

Wang Yanglingxi, Sun Kai, Zhang Wenling, Zhang HaiTao, Wang Chong

机构信息

The Clinical College of Jining Medical University, Ji-Ning City, Shandong Province, People's Republic of China.

Deparment of Neurosurgery, Daping Hospital, Army Medical University, Chongqing, People's Republic of China.

出版信息

J Neurol Surg B Skull Base. 2021 Jul;82(Suppl 3):e285-e294. doi: 10.1055/s-0039-3402040. Epub 2020 Jan 14.

Abstract

This study was aimed to investigate the effects of microvascular decompression (MVD) on sleep disorders and obsessions in trigeminal neuralgia.  Clinical data from 115 patients with trigeminal neuralgia treated with MVD from August 1, 2017 to May 31, 2018 at Jining First People's Hospital were analyzed retrospectively. The preoperative and postoperative risk factors for sleep disorders and obsessions, as well as the effects of MVD on sleep disorders and obsessions, were examined.  In 115 patients, there were significant differences in preoperative sleep disorders associated with sex, monthly household income, pain in multiple branches, visual analog scale (VAS) score, and Self-Rating Depression Scale (SDS) score (  < 0.05). Preoperative obsessions were significantly different according to age, gender, pain in multiple branches, monthly household income, VAS score, and Self-Rating Anxiety Scale (SAS) score groups (  < 0.05). A 1-year recurrence was positively correlated with sleep disturbance (odds ratio = 3.829) and obsessions (odds ratio = 4.507). In addition, the results revealed a negative correlation between the manipulation of trigeminal neuralgia and postoperative sleep disorders (  ≥ 1.043). Moreover, there was a significant difference in sleep disorders and obsessions before and 1 year after MVD (  < 0.05).  For patients with trigeminal neuralgia, pain caused by sleep and obsession disorders should be examined early to identify an effective solution. Moreover, MVD, as a first treatment, is valuable for improving the physiological and psychological prognosis of patients.

摘要

本研究旨在探讨微血管减压术(MVD)对三叉神经痛患者睡眠障碍和强迫观念的影响。回顾性分析了2017年8月1日至2018年5月31日在济宁市第一人民医院接受MVD治疗的115例三叉神经痛患者的临床资料。研究了术前和术后睡眠障碍和强迫观念的危险因素,以及MVD对睡眠障碍和强迫观念的影响。115例患者中,术前睡眠障碍在性别、家庭月收入、多支疼痛、视觉模拟评分(VAS)和自评抑郁量表(SDS)评分方面存在显著差异(P<0.05)。术前强迫观念在年龄、性别、多支疼痛、家庭月收入、VAS评分和自评焦虑量表(SAS)评分组间存在显著差异(P<0.05)。1年复发率与睡眠障碍(比值比=3.829)和强迫观念(比值比=4.507)呈正相关。此外,结果显示三叉神经痛手术操作与术后睡眠障碍呈负相关(P≥1.043)。而且,MVD术前和术后1年的睡眠障碍和强迫观念存在显著差异(P<0.05)。对于三叉神经痛患者,应尽早检查由睡眠和强迫观念障碍引起的疼痛,以找到有效的解决办法。此外,MVD作为首选治疗方法,对于改善患者的生理和心理预后具有重要价值。

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