周围性面瘫177例临床分析  

Clinical analysis on 177 cases with Peripheral facial Paralysis

作　　者：余得志[1] 邱建新[1] 陶冶[1] 王节[1] 郑文雯[1] 

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉-头颈外科,合肥230022

出　　处：《中国中西医结合耳鼻咽喉科杂志》2008年第1期34-37,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的回顾性分析177例周围性面瘫患者的诊疗资料,探讨该病的最佳治疗方法。方法177例周围性面瘫患者,分为手术治疗和药物治疗两组。其中手术治疗组99例,分别经乳突径路、外耳道径路、乳突-颅中窝径路、颅中窝径路或迷路径路行面神经减压术51例,面神经吻合术及改道吻合术27例,面神经移植术21例;药物治疗组78例,采用扩血管、营养神经、抗炎、抗病毒等药物治疗。结果手术治疗患者中,面神经功能Ⅰ级恢复43例（43.43%）,Ⅱ级恢复23例（12.99%）,Ⅲ级23例（12.99%）,Ⅳ-Ⅵ级10例（5.64%）。药物治疗患者中,Ⅰ级恢复51例（65.38%）,Ⅱ级恢复12例（15.38%）,Ⅲ级13例（16.66%）,Ⅳ-Ⅵ级2例（2.56%）。全组患者中,面瘫在1个月内恢复者25例（14.12%）,2个月内恢复44例（24.85%）,3个月内恢复62例（35.02%）,半年内恢复124例（70.05%）。结论对于周围性面瘫的患者,应综合分析面瘫的病因,积极行相关定位与定量检查,采取合理的药物和（或）手术治疗,可以取得良好的康复效果。Objective To explore the most appropriate therapy for the treatment of Peripheral facial Paralysis based on a retrospective study on 177 Patients with the lesion. Methods A retrospective study was carried out among 177 cases with Peripheral facial Paralysis treated in our Hospital, treated in two ways respectively, i.e. 99 cases received surgical Procedures and another 78 cases got medical therapy. Among those treated by surgical Procedures, 51 were operated on with facial nerve decompression, 27 with end-to-end facial nerve anastomosis or re-routine end-to-end anastomosis, 21 with facial neurotization via mastoid Process approach, external acoustic meatus approach, mastoid-middle cranial fossa approach, middle cranial fossa approach or labyrinthine approach, while those treated by drug therapy, all received such agents like vessel dilators, neurotrophic agents, anti-inflammatory ones, anti-viruous ones and so on. Results Among the surgically treated cases, 43 cases （43.43%） showed with grade Ⅰ facial function recovery, 23 （12.99%） with a recovery of grade Ⅱ, 23 （12.99%） with grade Ⅲ and 10 （5.64%） with grade Ⅳ to Ⅵ, while among those treated medically, 51 cases （65.38%） were with a facial function recovery of grade Ⅰ, 12 （15.38%） with a recovery of grade Ⅱ, 13 （16.66%） with grade Ⅲ and 2 （2.56%） with grade Ⅳ to Ⅵ following the therapy, based on House-Brackmann facial nerve grading system. When evaluated taking all the cases as one whole group, 25 cases （14.12%） had their facial function recovered in 1 month, 44 （24.85%） recovered in 2 months, 62 （35.02%） in 3 months, and 124 （70.05%） in 6 months. Condusions The Patients with Peripheral facial Paralysis will be recovered much better only they are treated with ideally combined therapies with medication and/or surgery following an appropriate diagnostic Program composed of careful analysis on the etiology and comprehensive iuspeetion on the Pathological localization of facial Paralysis and quantify

关 键 词：周围性面瘫 诊断 治疗 

分 类 号：R745.1[医药卫生—神经病学与精神病学]