全程减压与常规显微血管减压术治疗面肌痉挛的疗效比较  

Comparison of efficiency of whole-range decompression versus traditional microvascular decompression for hemifacial spasm

作　　者：别小华[1] 薛俊刚[1] 袁武军[1] 常树林[1] 曹磊[1] 冯清亮 

机构地区：[1]西安交通大学附属红会医院功能神经外科,西安710054

出　　处：《山西医科大学学报》2015年第4期360-364,共5页Journal of Shanxi Medical University

摘　　要：目的比较常规面神经根部单纯血管减压和颅内段面神经全程减压的术后疗效及术后并发症,评价全程显微血管减压术治疗面肌痉挛的疗效。方法采用随机分组方式将自2009-01～2011-01西安市红会医院功能神经外科接受显微血管减压术的98例已经确诊为面肌痉挛的患者分为常规减压术组（n=49）和全程减压术组（n=49）,常规减压术组患者采用常规的显微血管减压术治疗面肌痉挛,全程减压术组采用面神经颅内段的全程减压的手术方式,手术后通过电话访问、信访以及门诊复诊的方式,随访患者的面肌痉挛改善程度和并发症的恢复情况。结果术后随访1年情况：常规减压术组术后面肌痉挛消失45例,减轻4例,无效0例;全程减压术组术后面肌痉挛消失46例,减轻2例,无效1例,两组病人均无复发病例。两组患者的治疗有效率差异无统计学意义（P〉0.05）。常规减压术组术后出现1例面瘫,1例脑脊液漏,1例耳鸣;全程减压术组术后出现3例面瘫,1例听力障碍,1例耳鸣;全程减压术组的并发症发生率为10.9%,常规减压术组的并发症发生率为4.4%。结论采用全程血管减压术治疗面肌痉挛和采用常规血管减压术治疗面肌痉挛的疗效差异并不明显,但全程减压术治疗面肌痉挛出现面瘫及听力障碍的机会较常规减压高。Objectlve To compare the postoperatlve effectlveness and compllcatlons of whole-range mlcrovascular decompresslon versus conventlonal decompresslon for hemlfaclal spasm（ HFS）.Methods All of the 98 patlents dlagnosed wlth faclal spasm were admltted ln Xl＇an Hong Hul-Hospltal to undergo the mlcrovascular decompresslon for hemlfaclal spasm from January 2009 to January 2011.Forty-nlne cases accepted the conventlonal mlcrovascular decompresslon and the other half were treated wlth the whole-range mlcrovascular decompresslon.The symptoms and compllcatlons were followed up by telephone,letters or outpatlent cllnlc.Results After 1-year follow-up,45 cases were completely cured ln conventlonal group,and 4 cases obvlously relleved.ln whole-range group,46 cases were completely cured,2 cases were obvlously relleved,and only 1 case was not lmproved.None relapsed ln the two groups.The effectlve rate was not statlstlcally dlfferent between the two groups（ P〉 0.05）.There was 1 case of faclal paralysls,1 case of cerebrosplnal fluld and1 case of tlnnltus ln conventlonal group.There was 3 cases of faclal paralysls,1 case of hearlng lmpalrment and 1 case of tlnnltus ln whole-range group.The lncldence of compllcatlons was 10.9% ln whole-range group and 4.4% ln conventlonal group.Concluslon The efflcacy of the two surgles has no slgnlflcant dlfference.The rlsk of faclal paralysls and hearlng lmpalrment ln whole-range mlcrovascular decompresslon seems to be a llttle hlgher than that ln the conventlonal decompresslon.

关 键 词：显微血管减压术 面肌痉挛 血管压迫 

分 类 号：R745.1[医药卫生—神经病学与精神病学]