【摘要】 目的 探讨责任血管穿行于面、听神经之间的面肌痉挛患者手术疗效。方法 选择2017年1月至2022年3月新乡医学院第一附属医院神经外科收治的167例面肌痉挛患者为研究对象。根据责任血管是否穿行于面、听神经之间将患者分为观察组(责任血管穿行于面、听神经之间，n=38)和对照组(责任血管未穿行于面、听神经之间，n=129)。比较2组患者的术中异常肌反应(AMR)完全消失率、手术疗效及术后并发症的发生率。结果 面神经完全减压后，对照组和观察组患者的AMR完全消失率分别为91.5%(118/129)、76.3%(29/38),观察组患者的AMR完全消失率显著低于对照组(χ~2=5.040,P<0.05)。术后1周，对照组和观察组患者的治愈率分别为93.8%(121/129)、78.9%(30/38);术后1 a,对照组和观察组患者的治愈率分别为96.1%(124/129)、92.1%(35/38)。术后1周，观察组患者的治愈率显著低于对照组(χ~2=5.875,P<0.05);术后1 a, 2组患者的治愈率比较差异无统计学意义(χ~2=0.345,P>0.05)。对照组和观察组患者术后1周颅神经并发症发生率分别为3.9%(5/129)、15.8%(6/38),观察组患者术后1周颅神经并发症发生率显著高于对照组(χ~2=4.973,P<0.05);术后1 a,对照组和观察组患者的颅神经并发症发生率分别为2.3%(3/129)、5.3%(2/38),2组患者术后1 a颅神经并发症发生率比较差异无统计学意义(χ~2=0.154,P>0.05)。结论 通过术中充分减压，可使责任血管穿行于面、听神经之间的面肌痉挛患者获得满意的远期手术效果。更多还原

【Abstract】 Objective To explore the surgical efficacy of hemifacial spasm caused by offending vessel passing between cranial nerve Ⅶ and Ⅷ.Methods A total of 167 patients with hemifacial spasm admitted to the Department of Neurosurgery, the First Affiliated Hospital of Xinxiang Medical University from January 2018 to March 2022 were selected as the study subjects.The patients were divided into the observation group(with the offending vessel passing between cranial nerve Ⅶ and Ⅷ,n=38) and the control group(without offending vessel passing between cranial nerve Ⅶ and Ⅷ,n=129) based on whether the responsible blood vessel passed between the cranial nerve Ⅶ and Ⅷ.The complete disappearance rate of intraoperative abnormal muscle response(AMR),surgical efficacy and the incidence of postoperative complications were compared between the two groups.Results The complete disappearance rate of AMR of patients in the control group and the observation group was 91.5%(118/129) and 76.3%(29/38),respectively after complete decompression of facial nerve.The complete disappearance rate of AMR of patients in the observation group was significantly lower than that in the control group(χ~2=5.040,P<0.05).One week after operation, the cure rate of patients in the control group and the observation group was 93.8%(121/129) and 78.9%(30/38),respectively; one year after operation, the cure rate of patients in the control group and the observation group was 96.1%(124/129) and 92.1%(35/38),respectively.The cure rate of patients in the observation group was significantly lower than that in the control group at one week after operation(χ~2=5.875,P<0.05);there was no significant difference in the cure rate of patients between the two groups at 1 year after operation(χ~2=0.345,P>0.05).The incidence of cranial nerve complications of patients in the control group and the observation group was 3.9%(5/129) and 15.8%(6/38),respectively at 1 week after operation; the incidence of cranial nerve complications of patients in the observation group was significantly higher than that in the control group at 1 week after operation(χ~2=4.973,P<0.05).One year after operation, the incidence of cranial nerve complications of patients in the control group and the observation group was 2.3%(3/129)and 5.3%(2/38),respectively; there was no significant difference in cranial nerve complications of patients between the two groups at 1 year after operation(χ~2=0.154,P>0.05).Conclusion For the hemifacial spasm patients with offending vessel passing between cranial nerve Ⅶ and Ⅷ,satisfactory long-term surgical efficacy can be achieved by thoroughly decompressing during surgery.更多还原