术前C反应蛋白/白蛋白比值对三叉神经痛微血管减压术后切口愈合不良的预测价值OA
Predictive value of preoperative C-reactive protein/albumin ratio for poor incision healing after microvascular decompression for trigeminal neuralgia
目的 探讨术前C反应蛋白/白蛋白比值(CAR)对三叉神经痛微血管减压术(MVD)后切口愈合不良的预测价值.方法 回顾性分析2019-03-2024-03于徐州医科大学附属医院进行MVD治疗的104例三叉神经痛患者的临床资料,根据术后手术部位切口愈合情况将104例三叉神经痛患者分为切口愈合良好组(n=86)和切口愈合不良组(n=18).收集患者术前C反应蛋白(CRP)、白蛋白(ALB)水平,计算CAR.采用受试者工作特征(ROC)曲线分析术前CAR对三叉神经痛MVD后切口愈合不良的预测价值,多因素Logistic逐步回归分析探讨三叉神经痛MVD后切口愈合不良的影响因素.结果 切口愈合不良组患者术前CRP、CAR高于切口愈合良好组,ALB低于切口愈合良好组(P<0.05).ROC曲线分析显示,术前CAR预测三叉神经痛MVD后切口愈合不良的AUC为0.919,明显大于术前CRP、ALB单独预测的0.792、0.874(Z=6.831、9.208,P<0.001).切口愈合不良组年龄、BMI、合并糖尿病占比、住院时间≥10 d占比、手术时间≥3 h占比、切口长度≥8 cm占比均高于切口愈合良好组(P<0.05).多因素分析显示,合并糖尿病(OR=2.280,95%CI:1.421～3.656)、手术时间≥3 h(OR=2.052,95%CI:1.320～3.190)、切口长度≥8 cm(OR=2.552,95%CI:1.263～5.158)、术前CAR≥0.22(OR=3.184,95%CI:1.744～5.811)是三叉神经痛MVD后切口愈合不良的危险因素(P<0.05).结论 术前CAR高表达是三叉神经痛MVD后切口愈合不良的独立危险因素,对预测三叉神经痛MVD后切口愈合不良具有较好的临床价值.
Objective To investigate the predictive value of preoperative C-reactive protein/albumin ratio(CAR)for poor incision healing after microvascular decompression(MVD)for trigeminal neuralgia.Methods The clinical data of 104 patients with trigeminal neuralgia who underwent MVD in the Affiliated Hospital of Xuzhou Medical University from March 2019 to March 2024 were retrospectively analyzed.According to the incision healing status at the surgical site after operation,104 patients with trigeminal neuralgia were divided into the good incision healing group(n=86)and the poor incision healing group(n=18).The preoperative levels of C-reactive protein(CRP)and albumin(ALB)were collected,and CAR was calculated.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of preoperative CAR for poor incision healing after MVD for trigeminal neuralgia,and multivariate Logistic stepwise regression analysis was used to explore the influencing factors of poor incision healing after MVD for trigeminal neuralgia.Results The preoperative CRP and CAR levels in the poor incision healing group were higher than those in the good incision healing group,while the ALB level was lower(P<0.05).ROC curve analysis showed that the area under curve(AUC)of preoperative CAR for predicting poor incision healing after MVD for trigeminal neuralgia was 0.919,which was significantly larger than that of preoperative CRP and ALB alone(0.792 and 0.874,respectively,Z=6.831,9.208,P<0.001).The poor incision healing group had higher age,BMI,proportion of patients with diabetes,proportion of hospital stay≥10 days,proportion of operation time≥3 hours,and proportion of incision length≥8 cm than the good incision healing group(P<0.05).Multivariate Logistic analysis showed that combined diabetes mellitus(OR=2.280,95%CI:1.421-3.656),operation time≥3 hours(OR=2.052,95%CI:1.320-3.190),incision length≥8 cm(OR=2.552,95%CI:1.263-5.158),and preoperative CAR≥0.22(OR=3.184,95%CI:1.744-5.811)were risk factors for poor incision healing after MVD for trigeminal neuralgia(P<0.05).Conclusion High expression of preoperative CAR is an independent risk factor for poor incision healing after MVD for trigeminal neuralgia,and it has good clinical value for predicting poor incision healing after MVD for trigeminal neuralgia.
史桃圳;肖维汉;王振;张永康;阴鲁鑫;高文昌
徐州医科大学附属医院,江苏 徐州 221006徐州医科大学附属医院,江苏 徐州 221006徐州医科大学附属医院,江苏 徐州 221006徐州医科大学附属医院,江苏 徐州 221006徐州医科大学附属医院,江苏 徐州 221006徐州医科大学附属医院,江苏 徐州 221006
医药卫生
C反应蛋白/白蛋白比值三叉神经痛微血管减压术切口愈合不良预测价值
C-reactive protein/albumin ratioTrigeminal neuralgiaMicrovascular decompressionPoor incision healingPredictive value
《中国实用神经疾病杂志》 2026 (6)
723-727,5
江苏省卫生健康委科研项目(编号:MQ2024025)
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