CAJ | 학술논문

目的探讨颅神经血管压迫症的MR血管断层成像(MRTA)的表现与微血管减压术疗效之间的相关性.方法回顾性分析223例行颅神经微血管减压术的患者,根据患者MRTA中的血管对神经的压迫程度和术后疗效进行分组、分级.223例患者分为无压迫组、轻度压迫组及重度压迫组;微血管减压术疗效分为3级,Ⅰ级为完全缓解、Ⅱ级为基本缓解,Ⅲ级为无缓解.用秩和检验的Kruskal-Wallis法比较无压迫组、轻度压迫组及重度压迫组各组间的手术疗效有无统计学差异;用Nemenyi法作各组间手术疗效优劣的两两比较.结果微血管减压术后缓解程度,无压迫组Ⅰ级为31例,Ⅱ级为13例,Ⅲ级为9例;轻度压迫组Ⅰ级为95例,Ⅱ级为11例,Ⅲ级为4例;重度压迫组Ⅰ级为48例,Ⅱ级为7例,Ⅲ级为5例.三组之间手术疗效的差异具有统计学意义(秩和检验值χ2=16.84,P<0.05).无压迫组、轻度压迫组与重度压迫组的平均秩次分别为134.21、102.37及110.04.轻度压迫组、重度压迫组与无压迫组的平均秩次之差分别为31.84、24.17,P值均<0.05.结论微血管减压术疗效与术前MRTA的表现具有密切相关性;轻度压迫组和重度压迫组的手术疗效优于无压迫组;MRTA对于微血管减压术适应证的选择及手术预后有指导作用.
목적 탐토로신경혈관압박증적MR혈관단층성상(MRTA)적표현여미혈관감압술료효지간적상관성.방법 회고성분석223례행로신경미혈관감압술적환자,근거환자MRTA중적혈관대신경적압박정도화술후료효진행분조、분급.223례환자분위무압박조、경도압박조급중도압박조;미혈관감압술료효분위3급,Ⅰ급위완전완해、Ⅱ급위기본완해,Ⅲ급위무완해.용질화검험적Kruskal-Wallis법비교무압박조、경도압박조급중도압박조각조간적수술료효유무통계학차이;용Nemenyi법작각조간수술료효우렬적량량비교.결과 미혈관감압술후완해정도,무압박조Ⅰ급위31례,Ⅱ급위13례,Ⅲ급위9례;경도압박조Ⅰ급위95례,Ⅱ급위11례,Ⅲ급위4례;중도압박조Ⅰ급위48례,Ⅱ급위7례,Ⅲ급위5례.삼조지간수술료효적차이구유통계학의의(질화검험치χ2=16.84,P<0.05).무압박조、경도압박조여중도압박조적평균질차분별위134.21、102.37급110.04.경도압박조、중도압박조여무압박조적평균질차지차분별위31.84、24.17,P치균<0.05.결론 미혈관감압술료효여술전MRTA적표현구유밀절상관성;경도압박조화중도압박조적수술료효우우무압박조;MRTA대우미혈관감압술괄응증적선택급수술예후유지도작용.
Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.