【作者】 许晖； 董江涛； 王惠； 王世龙； 王刚刚； 焦曦； 于春玲；

【Author】 XU Hui;DONG Jiang-tao;WANG Hui;WANG Shi-long;WANG gang-gang;JIAO-xi;YU Chun-ling;The First Affiliated Hospital of The Medical College of,Shihezi University;

【机构】 石河子大学医学院第一附属医院神经外科；

【摘要】 目的探讨电生理监测在面肌痉挛微血管减压术中的应用价值及对其疗效的影响。方法采用电生理监测术中面神经侧方扩散反应(LSR)的方法,对67例面肌痉挛的患者进行术中监测,根据监测结果对术中面神经减压效果进行评判,并将结果与79例未作电生理监测的患者进行近期和远期疗效对比,同时进行听力下降和面瘫等并发症发生情况的对比。结果监测组术后近期治愈率88.1%(59例),轻微面瘫1.49%(1例),听力下降5.97%(4例)。术后随访6～12个月,平均9.2个月,面瘫、听力下降均明显改善,手术远期治愈率为97.0%(65例);对照组:术后近期治愈率78.5%(62例),轻微面瘫16.5%(13例),听力下降22.8%(18例)。术后随访6～12个月,平均9.2个月,面瘫、听力下降均明显改善,手术远期治愈率93.7%(74例)。2组患者近期治愈率比较差异有统计学意义(P<0.05),监测组明显优于对照组;远期治愈率比较差异无统计学意义(P>0.05)。2组患者面瘫、听力下降等并发症发生率比较差异有统计学意义(P<0.05),监测组优于对照组。结论根据术中电生理监测结果,对面神经微血管减压术进行术中减压效果预判能够提高近期治愈率,对于责任血管的识别、减压效果和面听神经的保护具有重要意义,可以有效降低面瘫及听力下降等并发症的发生率。更多还原

【Abstract】 Objective To investigate the application value and clinical significance of neural electrophysiological monitoring on microvascular decompression(MVD)of hemifacial spasm.Methods The data of 146 patients treated with MVD under neurophysiological monitoring were analyzed retrospectively,67 patients with hemifacial spasm were monitored by electrophysiological monitoring of lateral diffusion reaction(LSR)of facial nerve during operation,and the decompression effect of facial nerve during operation was evaluated according to the monitoring results.The results were compared with the short-term and long-term results of 79 patients without electrophysiological monitoring,and the complications such as hearing loss and facial paralysis were compared.Results The short-term cure rate in monitoring group was 88.1 %(59 cases),slight facial paralysis was 1.49 %(1 case)and hearing loss was 5.97 %(4 cases)in the monitoring group.After 6 ～12 months follow-up(mean 9.2 months),the facial paralysis,hearing loss were significantly improved,the long-term cure rate was 97.0 %(65 In the control group,the short-term cure rate was 78.5 %(62 cases),slight facial paralysis was 16.5 %(13 cases)and hearing loss was 22.8 %(18 cases).After 6～12 months follow-up(mean 9.2 months),the facial paralysis,hearing loss were significantly improved,the long-term cure rate was 93.7 %(74 cases).The short-term cure rate of the two groups was significantly higher than that of the control group(p<0.05).There was no significant difference in long-term cure rate(p>0.05).The incidence of facial paralysis,hearing loss and other complications in the two groups were significantly different(p<0.05),and the monitoring group was better than the control group.Conclusion According to the intraoperative electrophysiological monitoring results,intraoperative decompression effect prediction of facial nerve microvascular decompression can improve the short-term cure rate.It has important significance for the recognition of responsible vessels,decompression effect and the protection of facial auditory nerve,and can effectively reduce the incidence of complications such as facial paralysis and hearing loss.更多还原