| 王 墨,吴明坤,张 阳,罗国轩,罗 成,张 勇.神经电生理监测下面肌痉挛微血管减压术的临床疗效及可行性分析[J].,2017,17(29):5673-5676 |
| 神经电生理监测下面肌痉挛微血管减压术的临床疗效及可行性分析 |
| Clinical Efficacy and Feasibility Analysis of Neurophysiological Monitoring in the Microvascular Decompression Surgery for Hemifacial Spasm |
| 投稿时间：2017-03-05 修订日期：2017-03-30 |
| DOI：10.13241/j.cnki.pmb.2017.29.016 |
| 中文关键词: 神经电生理 微血管减压术 面肌痉挛 临床疗效 |
| 英文关键词: Neurophysiological Microvascular decompression Hemifacial spasm Clinical effect |
| 基金项目:广州市科技计划项目（穗科创字〔2016〕172号） |
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| 摘要 目的：探讨微血管减压术（MVD）联合神经电生理监测治疗面肌痉挛（HFS）的临床疗效及可行性，为临床治疗提供参考。方法：选取2014年6月-2016年9月在广东省第二人民医院接受治疗的HFS患者80例，按随机数字表法分为观察组和对照组各40例，两组均行MVD治疗，观察组在MVD中联用神经电生理监测。记录观察组患者面肌旁路传导反应（LSR）波形消失时处于哪个手术阶段，听觉脑干诱发电位（BAEP）波形中的V波下降超过50%情况；对比手术后1 d、手术后3个月两组的临床疗效以及手术后1 d并发症发生率。结果：LSR波形在探查桥小脑角时消失6例（15.00%），在神经减压时消失33例（82.50%），1例手术结束时仍未消失（2.50%）；BAEP波形V波下降超过50%有5例；手术后1 d观察组的总有效率显著高于对照组，差异有统计学意义（P<0.05），手术后3个月两组总有效率对比差异无统计学意义（P>0.05），两组手术后3个月总有效率显著高于手术后1 d，差异均有统计学意义（P<0.05）；手术后1 d两组患者面瘫、耳鸣发生率比较差异无统计学意义（P>0.05），观察组眩晕、听力受损发生率较对照组更低，差异有统计学意义（P<0.05）。结论：在神经电生理监测下行MVD治疗HFS患者，临床疗效明显，并发症发生率少，安全性高，较单用MVD治疗优势明显，值得临床推广。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical efficacy and feasibility of microvascular decompression (MVD) combined with neu- rophysiological monitoring in the treatment of hemifacial spasm (HFS), and provide reference for clinical treatment. Methods: 80 cases of patients with HFS treated in Guangdong No.2 People's Hospital from June 2014 to September 2016 were selected, and divided into ob- servation group and control group according to the random number table method, 40 cases in each group. The two groups were given MVD treatment,and the observation group was given neurophysiological monitoring combined with MVD. In which operation stage the lateral spread response (LSR) of observation group disappeared were recorded, and the situation of Brainstem Auditory Evoked Potential (BAEP) waveforms in the V wave decreased by more than 50% were also recorded. The clinical effects of the two groups 1 d and 3 months after operation and the complication rate 1d after operation were compared. Results: 6 cases (15.00%) of LSR waveform disap- peared during the exploration of the cerebellopontine angle, and 33 cases (82.5%) disappeared during the nerve decompression, 1 case (2.50%) disappeared at the end of surgery. There were 5 cases BAEP waveforms in the V wave decreased more than 50%. The total effective rate 1d after operation of the observation group was significantly higher than that of the control group, the difference was statisti- cally significant (P<0.05). There was no significant difference in the total effective rates 3 months after operation between the two groups.The total effective rates of the two groups 3 months after operation were significantly higher than 1d after operation, he difference was statistically significant (P<0.05). There was no significant difference in the incidence of facial paralysis and tinnitus between the two groups 1 d after operation (P>0.05). The incidence of vertigo and hearing loss in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: The clinical curative effect MVD treatment of patients with HFS under neurophysiological monitoring is obvious, and the complication rate is low, while the safety is high. Compared with MVD alone, it has obvious advantages, which is worthy of clinical promotion. |
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