【摘要】 目的分析面肌痉挛患者微血管减压术(MVD)中侧方扩散反应(LSR)监测对疗效的预测作用。方法面肌痉挛患者45例,均行MVD术治疗,分别于术中微血管减压前后进行LSR监测。分别于术后第1、7天及术后3个月采用自我评价量表评估手术效果。分析减压后LSR变化与疗效的关系。结果 40例减压后LSR即刻消失(LSR消失组);5例LSR未即刻消失(LSR未消失组),其中1例下降86%、2例下降幅度不足50%、1例无变化、1例因持续自发放电未引出LSR。术后第1天,LSR消失组治愈31例、好转9例,LSR未消失组治愈1例、好转1例、无效3例;术后第7天,LSR消失组治愈35例、好转5例,LSR未消失组治愈1例、好转2例、无效2例;术后3个月,LSR消失组治愈39例、好转1例,LSR未消失组治愈1例、好转2例、无效2例。随访3~88个月,LSR消失组全部治愈,LSR未消失组好转3例、无效2例。术后各观察时点LSR消失组治愈和好转比例均高于LSR未消失组,减压后LSR是否消失与疗效存在相关性(P均<0.05)。结论面肌痉挛患者MVD术中LSR监测结果与疗效有关,减压后LSR消失者治愈及好转率较高。更多还原

【Abstract】 Objective To investigate the prognostic value of intraoperative lateral spread response( LSR) monitoring in the treatment of hemifacial spasm( HFS) by microvascular decompression( MVD). Methods Forty-five patients with primary HFS treated by MVD. During operations,we performed LSR monitoring before and after MVD respectively. All patients were assessed after operation on day 1 and 7,and at 3 month after surgery by self-assessment scale. We analyzed the relationship between the change of LSR and prognosis. Results In 40 patients,the LSR disappeared immediately after decompression( LSR disappeared group). In the remaining 5 patients,the LSR did not vanish immediately after decompression( LSR non vanishing group),one patient’s LSR decreased 86%,2 patients’ LSR decreased above 50%,1 patient had no change,and in 1 patient,LSR was not detected from the start. On day 1 after operation,in the LSR disappeared group,HFS was relieved totally in 31 patients,9 patients described improvement; in the LSR non vanishing group,1 patient totally relieved,1 patient improved,and 3 patients failed. On day 7,in the LSR disappeared group,HFS was relieved totally in 35 patients,5 patients described improvement; in the LSR non vanishing group,1 patient totally relieved,2 patient improved,and 2 patients failed. After 3 month,in the LSR disappeared group,HFS was relieved totally in 39 patients,1 patients described improvement; in the LSR non vanishing group,3 patient improved,and 2 patients failed. After 3-month to88-month follow-up,in the LSR disappeared group,all the 40 patients cured,in the LSR non vanishing group,3 patients improved and 2 patients failed. At all the postoperative observing time,the proportion of cure and improvement of the LSR disappeared group was higher than that of the LSR non vanishing group. Statistical analysis found a significant correlation between the relief of LSR and clinical outcome( all P < 0. 05). Conclusion LSR monitoring of HFS patients in MVD is correlated with the curative effect,and the rate of cure and improvement is higher in patients with disappeared LSR after decompression.更多还原