尼莫地平在微血管减压术后迟发性面瘫防治作用中的研究  

Research of the nimodipine in the prevention of delayed facial palsy after microvascular decompression

作　　者：詹傲[1] 石全红[1] 熊伟茗[1] 谭赢[1] 谢延风[1] 但炜[1] 王佳[2] 

机构地区：[1]重庆医科大学附属第一医院神经外科,重庆400016 [2]重庆医科大学附属大学城医院妇产科,重庆401331

出　　处：《重庆医学》2014年第22期2836-2838,共3页Chongqing medicine

基　　金：国家临床重点专科建设项目经费资助(财社[2011]170号)

摘　　要：目的：探讨血管扩张药物尼莫地平在防治面肌痉挛患者微血管减压术（MVD）后迟发性面瘫（DFP）中的作用。方法回顾性分析2009年1月至2012年3月行M VD术的193例面肌痉挛患者。根据术后是否应用血管扩张药将病例分为两组，实验组72例，术后第1天起服用血管扩张药尼莫地平，持续2周；对照组121例，术后未予以尼莫地平治疗。随访时间为6～12个月。观察比较两组患者术后迟发性面瘫的发生率、发作等级、术后发病时间及持续时间。结果实验组中有6例发生迟发性面瘫，发病率为8．3％（6/72），发病时间为（14．5±5．2）d，发病持续时间为（41．3±14．4）d；对照组有11例发生迟发性面瘫，发病率为9．1％（11/121），发病时间为（12．2±7．4）d ，发病持续时间为（55．7±36．4）d。各指标组间比较，差异无统计学意义（ P＞0．05）。术后迟发性面瘫发作等级按 House-Brackman评级，实验组中4例为Ⅱ级，2例为Ⅲ级；对照组中2例为Ⅱ级，6例为Ⅲ级，3例为Ⅳ级，两组比较差异有统计学意义（P＜0．05）。结论 MVD术后迟发性面瘫受多种病因影响，血管扩张药物能降低迟发性面瘫的发病程度，在促进面瘫恢复方面有一定的作用。Objective To research the effect of nimodipine in the prevention and treatment of delayed facial palsy after microvas-cular decompression .Methods A retrospective analysis was taken from January 2009 to March 2012 ,193 cases of patients with fa-cial spasm undergoing MVD in our department .According to whether applied vasodilators after operation ,all cases were divided into two groups ：the experimental group（72 cases）with the treatment of nimodipine for two weeks ;the control group（121 cases） ,and not treated with nimodipine .The follow-up time was 6-12 months .Observe and compare the incidence ,level of delayed facial paraly-sis onset time and disease duration time between two groups .Results In the experimental group had 6 cases of late facial paralysis , the incidence was 8 .3% （6/72） ,onset time was （14 .5 ± 5 .2）days ,disease duration was （41 .3 ± 14 .4）days .The incidence of control group was 9 .1% （11/121） ,onset time was （12 .2 ± 7 .4）days ,disease duration was （55 .7 ± 36 .4）days .There was no significant difference between groups（P〉0 .05） .According to House-Brackman classification ,there were 4 cases of grade Ⅱ and 2 cases of grade Ⅲ in experimental group .In control group ,there were 2 cases of grade Ⅱ ,6 cases of grade Ⅲ ,3 cases of grade Ⅳ .The differ-ence was statistically significant （P〈0 .05） .Conclusion The delayed facial paralysis is influenced by a variety of causes .Vasodila-tor drugs can reduce the incidence of delayed facial paralysis ,and play a certain role in promoting facial paralysis restored .

关 键 词：面肌痉挛 显微血管减压术 迟发性面瘫 尼莫地平 

分 类 号：R745.12[医药卫生—神经病学与精神病学]