面肌痉挛微血管减压术后短期缓解作为长期疗效预测因素的探讨  

Investigation of short-term resolution as a predictor of long-term cure of microvascular decompression in hemifacial spasm

作　　者：张聪 王丰[1] 林元相[1] 余良宏[1] 康德智[1] 魏书山 

机构地区：[1]福建医科大学附属第一医院神经外科,福州350005

出　　处：《中华医学杂志》2017年第39期3085-3088,共4页National Medical Journal of China

基　　金：福建省临床重点专科建设项目

摘　　要：目的探讨面肌痉挛（HFS）微血管减压术（MVD）后短期缓解（7d内）能否作为长期疗效（〉6个月）的预测因素。方法回顾性分析福建医科大学附属第一医院从2008年8月至2016年5月间行MVD术的159例面肌痉挛患者的病历资料，记录患者术后即刻至术后7d、最近1次随访时（〉6个月）的症状分级（Cohen Albert标准）及有无迟发性治愈发生。结果159例HFS患者行MVD术，术后7d内观察到缓解的患者的治愈率显著高于术后7d持续抽搐组（P〈0．05），且HFS术后患者治愈率（y）和7d内缓解的天数（x）高度正相关，Y=-0．707X2＋9．724X＋67．442（P〈0．05）。对术后7d疗效和最后一次随访时疗效的相关预后因素进行Logistic回归分析后，发现术后即刻症状分级和术后7d平均症状分级为预后相关因素（P〈0．001），迟发性治愈的发生率41．5％（66／159）。结论MVD术后7d内至少有1d观察到抽搐缓解即预测着术后的治愈。Objective To investigate whether the short-term relief of spasm （within 7 days） after microvascular decompression （MVD） for hemifacial spasm （HFS） can be used as a prognostic factor of long-term outcome （ 〉 6 months）. Methods The clinical characteristics and follow-up data （ completely recorded） of 159 patients who had HFS and underwent microvascular decompression surgery in the first Affiliated Hospital of Fujian Medical University from August 2008 to May 2016 were analyzed retrospectively. The collected data focus on symptom relief in a time course：immediately after MVD, 7 days after MVD and the last follow-up （ 〉 6 months ） by using Cohen-Albert grading. Results In a total of 159 patients underwent MVD were followed up for more than 6 months. Compared to persist spasm group within 7 days after MVD, the cure rate was significantly higher in the spasm symptom relief group within 7 days after MVD （ P 〈 0. 05 ）. The cure rate of MVD （y） and the number of days within 7 days of relief （x） were highly relevant, y = - 0. 707x^2 ＋ 9. 724x ＋ 67. 442 （ P 〈 0. 05）. By using univariate Logistic regression analysis, we found that the prognostic factors of long-term curative effect were the symptom scale immediately after MVD and the average symptom scale in the 7 days after MVD （ P 〈 0. 001 ）. The incidence of delayed cure was 41.5% （66/159）. Conclusion In the 7 days after MVD, at least 1 day of symptom remission can predict the cure of HFS.

关 键 词：面肌痉挛 微血管减压术 即刻缓解 迟发性治愈 预后因素 

分 类 号：R651.3[医药卫生—外科学]