【作者】 马云峰；

【导师】 姜勇；

【作者基本信息】 山东大学 ， 外科学（专业学位）， 2016， 硕士

【摘要】 背景及目的：原发性三叉神经痛(Idiopathic trigeminal neuralgia, ITN)、面肌痉挛(Hemifacial spasm, HFS)是桥小脑角区(CPA)主要的功能性神经外科疾病,由于共同的发病机制,又称为颅神经血管压迫综合症(Neurovascular compression syndrome, NVCS),微血管减压术(Microvascular decompression, MVD)为治疗该疾病的首选外科治疗方法。本研究通过对我科诊断为NVCS并经MVD治疗的患者的临床资料进行回顾性分析,探讨其临床特征、手术技术、并发症等。以期进一步提高手术疗效。方法：回顾性分析2014年1月至2016年3月我科所收治颅神经血管压迫综合症并行微血管减压术患者22例的临床资料,通过门诊及电话回访统计其预后情况,并对相关数据进行统计学分析。结果：三叉神经痛组术后症状立即消失9例(90.0%),明显减轻1例(10.0%)。面肌痉挛组术后立即控制症状10(83.3%),2例症状减轻(16.7%)。总有效率为86.4%。并发症主要包括颅内低压症状13例,发热3例,暂时性听力下降1例,疱疹1例,轻度面瘫2例,面瘫均在术后第10d出现,经治疗后后恢复正常。未出现偏瘫以及死亡病例。患者的年龄、性别、患侧、病程、压迫程度与预后效果间无明显的相关性。结论：1.采用MVD治疗ITN、HFS安全且疗效确定。2.合理的体位和骨窗选择、规范化的手术操作、准确的显露、熟练的垫隔技术以及及时防治术后并发症,均是提高手术效果的关键因素。更多还原

【Abstract】 Objective:Microvascular decompression (MVD)is an effective surgical treatment for the syndromes of cranial nerves including trigeminal neuralgia, hemifacial spasm induced by vascular compression. The clinical data of 22 patients with the vascular compression syndromes of cranial nerves, who underwent microvascular decompression in our department were analyzed retrospectively. We aim to explore the clinical value of microvascular decompression in the treatment of functional brain diseases, choice in the treatment and the prevention of complications, In order to enhance the treatment efficacyMethods:The clinical data of 22 patients with neurovascular compression syndrome, who underwent microvascular decompression from January 2014 to March 2016 in our department, were analyzed retrospectively. Analyze the contributing factors of prognosis of NVCS depend on follow up results. Results:In the group of trigeminal neuralgia, the operation efficiency was 90%. In the group hemi facial spasm, the operation efficiency was 83.3%. The total effective rate was 846.4%. Complication:postoperative intracranial hypotension in 13 cases;2 cases of fever; herpes in 1 cases; temporary hearing loss in 1 case;1 case of facial numbness. No patients died.Conclusion:MVD is an effective and safe treatment for Idiopathic trigeminal neuralgia and Hemifacial spasm. The correct position, suitable bone hole and skilled microsurgical technique may affect the outcome and incidence of complications.更多还原