神经内镜在面肌痉挛微血管减压术中的应用研究  

Neuroendoscopy in microvascular decompression for hemifacial spasm

作　　者：陈剑[1] 孙彦春[1] 胡庆雷[1] 王召平[1] 薛健[1] 种衍军[1] 

机构地区：[1]济宁市第一人民医院神经外二科,272111

出　　处：《中华神经医学杂志》2011年第1期59-62,共4页Chinese Journal of Neuromedicine

摘　　要：目的 探讨神经内镜在显微血管减压术（MVD）治疗面肌痉挛（HFS）的应用价值.方法 济宁市第一人民医院神经外二科自2006年12月至2009年12月应用神经内窥镜辅助下MVD治疗HFS患者118例,回顾性分析患者的临床资料和疗效.结果 术中单纯经显微镜下发现责任血管的共106例（89.83%）,其中有7例患者在神经内镜辅助下再次发现其它责任血管压迫;8例（6.78%）在显微镜下未见明显血管压迫,但经神经内镜发现有责任血管的存在.显微镜下减压完成后再用神经内镜观察,发现Teflon棉片未减压完全,需再次调整的17例（14.41%）;术后102例（86.44%）痉挛立即消失,11例（9.32%）逐渐消失,3例（2.54%）部分缓解,2例（1.70%）无明显减轻,轻度复发.无脑脊液漏、偏瘫、死亡等严重并发症发生.结论 神经内窥镜辅助下的MVD能清晰显示神经血管的解剖关系,减少对脑干、各颅神经的牵拉和重要血管的损伤,对提高手术疗效、减少复发率和术后并发症有重要价值.Objective To explore the value ofneuroendoscope in microvascular decompression for treatment of primary hemifacial spasm. Methods One hundred and eighteen patients with hemifacial spasm, admitted to our hospital from December 2006 to December 2009, underwent endoscope-assisted microvascular decompression via suboccipital retrosigmoid approach; their clinical data and treatment efficacy were retrospectively analyzed. Results The offending vessels were found in 106 patients （89.83%） under microscope, of which 7 （5.93%） were again found other offending vessels under neuroendoscope. Eight patients （6.78%） were noted as no significant vascular compression under microscope, but the offending vessels of these patients existed under endoscope. Seventeen patients performed decompression with Teflon cotton under microscope needed modification when they were checked under endoscope. The symptoms of 102 patients （86.44%） disappeared immediately after the operation; 11 （9.32%） disappeared gradually; 3 （2.54%） had partial remission and 2 （1.70%） had no significantly remission. No serious complications, including cerebrospinal leakage, paralysis and death, were noted. Conclusion Endoscope-assisted microvascular decompression, by improving the observation of the anatomic neurovascular relation, decreasing the damage to the brain stem, nerves and important vessels, can improve the surgical treatment, and reduce the recurrence rate and postoperative complications.

关 键 词：神经内窥镜 面部单侧痉挛 微血管减压术 

分 类 号：R651.3[医药卫生—外科学]