神经电生理监测异常肌反应在面肌痉挛术中的作用  

Use of intraoperative electrophysiological monitoring of abnormal muscle response in surgery for hemifacial spasm

作　　者：贾力[1] 傅先明[1] 姜晓峰[1] 牛朝诗[1] 邓大丽[1] 何金超 李仲森 汪业汉[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科,合肥230001

出　　处：《中国临床神经外科杂志》2015年第5期262-264,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的评价异常肌反应(AMR)监测在面肌痉挛微血管减压术(MVD)中的应用价值。方法 2011年4月至2013年7月收治的88例面肌痉挛患者,均行MVD治疗,采用神经电生理监测AMR波指导手术。结果术前所有患者均监测到AMR波,压迫面神经的血管减压后76例(86.4%)AMR波消失,12例(13.7%)AMR波未消失。术后随访结果6个月,AMR波消失的76例患者中,75例面肌痉挛消失,1例痉挛程度较术前明显缓解;AMR波未消失的12例患者,8例面肌痉挛消失,3例较术前明显缓解,1例无效。结论面肌痉挛患者MVD术中监测AMR波有助于鉴别责任血管、评价手术减压效果、判断手术后患者的预后。Objective To explore the value of intraoperative electrophysiological monitoring of abnormal muscle response （AMR） to microvascular decompression （MVD） and the relationship between the change in AMR and the clinical outcome in the patients with hemifeial spasm （HFS）. Methods MVD was performed under the intraoperative eleetrophysiological monitoring of AMR in 88 patients with HFS, in whom no muscle relaxant was used. The relationship between the changes in AMR and surgical outcome was analysed. Results The characteristic AMR of HFS was found in all the patients with HFS before the incision of dura mater. AMR disappeared after MVD in 76 patents （86.4%）, of whom, 75 were perfectly recovered from their HFS and 1 imperfectly 6 months after MVD. AMR did not disappeared after MVD in 12 patients （13.6%）, of whom, 8 were perfectly recovered from their HFS, 3 imperfectly and 1 still had HFS 6 months after MVD. Conclusion The intraoperative eleetophysiologieal monitoring of AMA during MVD is very useful to differentiating the responsible vessel for HFS and to assessing the effect of MVD on HFS.

关 键 词：面肌痉挛 微血管减压术 术中神经电生理监测 异常肌反应 

分 类 号：R745.12[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]