 英语晨读 · 山东省立医院疼痛科英语晨读已经坚持10余年的时间了，每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯，二是可以学习前沿的疼痛相关知识。我们会将晨读内容与大家分享，助力疼痛学习。 本次文献选自Kourilsky A, Palpacuer C, Rogers A, Chauvet D, Wiart C, Bourdillon P, Le Guérinel C. Multivariate models to predict pain recurrence and sensitive complications after percutaneous balloon compression in trigeminal neuralgia. J Neurosurg. 2022 Apr 22:1-10.本次学习由王珺楠副主任医师主讲。 Among the variables identified as predicting factors, we suspected and identified a multicollinearity issue between the occurrence of a hemorrhagic episode during surgery and compression time of the balloon. It turned out that all patients with hemorrhagic episodes during surgery had a compression time with the balloon longer than 60 seconds. Hence, we decided to keep only the compression time as an explanatory variable for time to recurrence, as it has a much greater pathophysiological effect. 在被确定为预测因素的变量中，我们怀疑并确定了手术期间出血的发生与球囊压迫时间之间存在多重共线性问题。结果发现所有手术中出血的患者球囊压迫时间均超过60秒。因此，我们决定仅保留压迫时间作为复发时间的解释因素，因为具有更大的病理生理效应。 The 8 remaining variables were entered in a multivariate Cox model. At the end of the stepwise selection process, the following 6 variables were retained in the final model constructed on 131 patients with 66 events: duration of presurgical symptoms > 10 years (HR 5.57, 95% CI 2.48–12.50) or between 3 and 10 years (HR 3.26, 95% CI 1.46–7.24) vs < 3 years, involvement of the V3 branch in the pain (HR 0.60, 95% CI 0.35–1.02), atypical pain (HR 2.55, 95% CI 1.41–4.62), diagnosis of MS (HR 1.70, 95% CI 0.91–3.19), use of a universal surrogate Fogarty balloon (HR 4.08, 95% CI 1.79–9.33), and a duration of compression > 60 seconds (HR 0.43, 95% CI 0.23–0.79) (Table 3). A nomogram was constructed to estimate the probability of being free of pain at the median survival time, i.e., after 2 years of follow-up (Fig. 2). 其余8个变量输入多变量Cox模型中。在逐步选择结束时，以下6个变量被保留在131例66个事件的患者的最终模型中：术前症状持续时间>10年(HR 5.57,95%CI 2.48-12.50)或3-10年(HR 3.26,95%CI 1.46-7.24) VS <3年，疼痛累及V3支(HR 0.60,95% CI 0.35-1.02)，非典型疼痛(HR 2.55, 95% CI 1.41-4.62)，MS病史 (HR 1.70, 95% CI 0.91-3.19)，使用通用Fogarty球囊(HR 4.08, 95% CI 1.79-9.33)，压迫持续时间>60秒(HR 0.43, 95% CI 0.23-0.79)(表3)。图2预测列线图为预测中位随访时间(即随访2年后)疼痛复发的风险(图2)。 Occurrence of Severe Sensitive Complications of Surgery Among the 128 patients for whom we collected the severe sensitive complication status, 26 (20%) presented one or more of the contributing events (Table 4). 手术后严重感觉并发症的发生在我们收集了严重感觉并发症的128例患者中，26例（20%）出现了一个或多个相关事件（表4）。 Table 1 depicts the proportions of severe sensitive complications associated with the different variable categories. Four variables were associated with the occurrence of a severe sensitive complication at the significance level of 20%, namely the duration of presurgical symptoms, the side of the pain, the duration of balloon compression, and the occurrence of a CSF leak through the cannula. These four variables had a limited number of missing values and were included in the multivariate analysis. 表1描述了与不同变量类别相关的严重感觉并发症的比例。在20%的显著性水平上，四个变量与严重感觉并发症的发生相关，即术前症状的持续时间，疼痛的侧别，球囊压迫的持续时间，以及通过套管发生脑脊液漏。这四个变量的缺失值数量有限，被纳入多变量分析。
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