微血管减压术治疗原发性面肌痉挛的结果评价  

Evaluation of the results ofmicrovascular decompression for primary hemifacial spasm

作　　者：谯飞[1] 何家全[1] 任海波[1] 冯浩 陈兵 QIAO Fei;HE Jiaquan;REN Haibo;FENG Hao;CHEN Bing(Department of Neurosurgery,Nanchong Central Hospital/the Second Clinical Medical College of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院第二临床医学院南充市中心医院,四川南充637000

出　　处：《中国实用神经疾病杂志》2018年第19期2149-2153,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的评价微血管减压术(MVD)治疗原发性面肌痉挛(HFS)患者的疗效和术后相关并发症。方法回顾性收集2010-01—2017-02在川北医学院第二临床医学院接受MVD治疗的HFS患者105例为研究对象,基于患者术后1a面肌痉挛有无缓解,将患者分为有效组和无效组。比较2组年龄、性别、痉挛部位、病程、合并高血压、糖尿病、责任血管与预后的关系,并收集患者术后并发症的相关资料。结果 1a后96例(91.4%)患者面肌痉挛明显缓解或治愈。在无效组中,患者多与病程长和合并椎动脉复合血管压迫有关。术后发生面瘫5例,听力下降4例,眩晕2例,皮下积液10例,颅内感染2例,无颅内出血和死亡病例。结论 MVD是面肌痉挛安全有效的治疗手段,患者在药物或肉毒素治疗无效或反复时,需及时考虑MVD治疗的可能。术前准确的评估和熟练细致的操作可以提高有效率,并且降低并发症。Objective To evaluate the curative effect and postoperative complications of microvascular decompression（MVD） for primary hemifacial spasm（HFS）. Methods 105 cases of HFS patients were retrospectively analyzed in the Second Clinical Medical College of North Sichuan Medical College from January 2010 to February 2017.Based on the alleviation of the spasm,the 1 year outcomes were classified valid group and invalid group,we compared the two groups＇prognosis factors including age,sex,side,duration of onset,hypertension,diabetes mellitus and offending vessels.We also collected the postoperative complications of the patients. Results 96 patients （91.4%） had obvious remission and cured state,Invalid group were inclined to long duration of onset and multiple compression vessel with vertebral artery.The number of facial palsy,hearling loss,vertigo,seroma,intracranial infection were 5,4,2,10,2 respectively.We had no intracranial hemorrhage and death in our series. Conclusion MVD is a safety and effective solution for HFS,when this type of patients encount repeated symptoms or invalid outcome after drugs administration and botulinum toxin injection,they should consider MVD in time.In order to increase the efficiency and reduce the complications.the surgeon＇s accurate preoperative assessment and skilled meticulous operation play an important role.

关 键 词：面肌痉挛 神经肌肉疾病 肉毒素 微血管减压术 责任血管 

分 类 号：R741.02[医药卫生—神经病学与精神病学]