面肌痉挛延迟治愈现象临床研究  

The delayed resolution for hemifacial spasm

作　　者：王晓松[1] 陈国强[1] 王林[1] 郑佳平[1] 郭宇鹏[1] 梁晖[1] 武晋廷[1] 左焕琮[1] 张建国[2] 

机构地区：[1]清华大学玉泉医院神经外科,北京100049 [2]首都医科大学附属北京天坛医院神经外科

出　　处：《中华神经外科杂志》2013年第12期1208-1211,共4页Chinese Journal of Neurosurgery

摘　　要：目的针对面肌痉挛患者在接受显微血管减压术后出现的延迟治愈现象进行研究，以获得可信的参考数据来指导预后评估和决定再次手术的时机。方法回顾分析300例具有延迟治愈现象的面肌痉挛患者资料，用统计软件SPSS15．0对资料进行数据处理。结果延迟治愈时间平均129．0d，中位数为50d，95％CI（105．4，152．5）d。延迟治愈时间与年龄（P=0．045）、病程（P=0．029）呈正相关，与术后抽动减轻程度呈负相关（P〈0．001）。42．7％患者存在静止期，平均1．36d，57．3％的患者静止期不超过24h。结论至少随访2年后再统计治愈率。如超过半年，面部肌肉抽动症状无缓解甚至持续加重；或已超过2年，面部仍有抽动者可考虑再次手术探查（症状明显缓解者除外）；对于年龄较大且病史较长者，需要适当延长随访时间。Objective The purpose of this research is to find a credible guideline for prognosis and re - exploration of Hemifacial spasm. Methods To analyze the data of 300 patients with delayed resolution after MVD. Descriptive statistics were performed with SPSS 15.0. Results The mean of time of delayed resolution was 129. 0 days, M = 50. 0 days. The 95% confidence interval（95% CI ） of delayed resolution was （ 105.4,152.5 ） days. Age （ P = 0. 045 ） , course of disease （ P = 0. 029 ） , and post - surgery tic severity （ P 〈 0. 001 ）were significant influences on the delayed resolution. Silent period was found in 42. 7% patients. The mean of silent period was 1.36 days, 57.3% within 24 hours. Conclusion The statistical time of cure rate should not be less than 2 years. Re - operation was reasonable if the symptoms persist more than 2 years （ except for the cases of symptoms were relieved ） or tend to get worse progressively when followed at least six months. The follow time would been prolonged for eider and/or long suffering.

关 键 词：延迟治愈 面肌痉挛 显微血管减压术 再次手术 

分 类 号：R651.3[医药卫生—外科学]