面肌痉挛微血管减压术中隐匿性责任血管的辨别及处理  

Recognition and management of hidden related vessel during the operation of microvascular decompression for hemifacial spssm

作　　者：吴国庆[1] 吴国宏[1] 王蕾[1] 尹卫宁[1] 刘玉光[1] 

机构地区：[1]青岛大学附属青岛市立医院神经外科,266071

出　　处：《中华医学杂志》2010年第23期1625-1627,共3页National Medical Journal of China

摘　　要：目的 探讨面肌痉挛微血管减压术中隐匿性责任血管的辨认和处理方法.方法 回顾性分析青岛市立医院85例面肌痉挛微血管减压术中7例隐匿性责任血管的面肌痉挛病人的临床资料.7例术中探查时未发现直接压迫面神经出脑干端（REZ）的责任血管,但在REZ近颅底侧发现游离状微血管随脑波动压迫REZ,我们采用了Teflon棉包绕REZ减压法,阻止血管对REZ的波动性压迫.结果 7例隐匿性责任血管,均为小脑前下动脉或其分支.术后6例症状立即缓解,1例发作减少,但2个月后完全缓解,随访半年以上无复发.结论 微血管减压术是面肌痉挛的首选治疗方法,术中找到责任血管,特别是隐匿性责任血管,合理解除REZ的压迫是手术疗效的保证.Objective To investigate the recognition and approach of the hidden related vascular in hemifacial spasm patients during the operation of microvascular decompression.Methods The clinical records of 85 patients of hemifacial spasm were analyzed at our hospital.The hidden related vessel was found in 7 patients.REZ（root entry zone）was surrounded bry Teflon cotton slice to separate the vessel from REZ. Results There were 7 patients of hidden related vessel in 85 patients.And the related vessels were anterioinferior cerebellar artery and its branches.The symptoms became totally relieved after operation and there Wag no recurrence.Conclusion The microvascular decompression is an effectively treatment for hemifacial spasm patients.Searching for the related vessel（particularly hidden related vessel）is the most important part of the operation.An effective decompression of REZ is the key point of operation.

关 键 词：面肌痉挛 微血管减压术 责任血管 

分 类 号：R651.1[医药卫生—外科学]