神经电生理监测在面肌痉挛显微血管减压术的应用  

Clinical application of neural electrophysiological monitoring in microvascular decompression for hemifacial spasm

作　　者：许晖[1] 董江涛[1] 王惠[1] 王世龙[1] 王刚刚[1] 于春玲[1] 赵冬[1] Xu Hui;Dong Jiangtao;Wang Hui;Wang Shilong;Wang Ganggang;Yu Chunling;Zhao Dong(Department of Neurosurgery,The First Affiliated Hospital,School of Medicin,Shihezi University,Shihezi,Xinjiang 832008,China)

机构地区：[1]石河子大学医学院第一附属医院神经外科,石河子832008

出　　处：《中国微侵袭神经外科杂志》2020年第12期550-552,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨电生理监测的侧方扩散反应(lareral spread response,LSR)在面肌痉挛(hemifacial spasm,HFS)显微血管减压术(microvascular decompression,MVD)的应用价值。方法回顾性分析146例HFS病例资料,其中对照组79例(MVD术中未监测LSR),监测组67例(MVD术中监测LSR)。结果术后近期(术后1周)治愈率监测组73.1%(49例),对照组78.5%(62例);远期(术后1年)治愈率监测组97.0%(65例),对照组93.7%(74例)。两组近期治愈率与远期治愈率差异,均无统计学意义(均P>0.05)。并发症:轻微面瘫监测组1例(1.49%),对照组13例(16.5%);听力下降监测组4例(5.97%),对照组18例(22.8%)。监测组并发症发生率低于对照组(均P <0.05)。术后随访6~12个月,平均9.2个月,两组面瘫、听力下降均明显改善。结论根据LSR监测结果,在MVD术中进行减压效果预判能够提高近期治愈率。对于责任血管辨识和面听神经保护具有重要意义,可显著降低面瘫与听力下降等并发症发生率。Objective To explore the application value of lareral spread response(LSR) of neural electrophysiological monitoring for hemifacial spasm(HFS) in microvascular decompression(MVD). Methods The data of 146 patients with HFS were analyzed retrospectively, including 79 in the control group(LSR was not monitored during MVD) and 67 in the monitoring group(LSR was monitored during MVD). Results In the short term(1 week after operation), the cure rate in the monitoring group was 73.1%(49 cases), and the control group was 78.5%(62 cases). In the long-term(1 year after operation), the cure rate in the monitoring group was97.0%(65 cases), and the control group was 93.7%(74 cases). The short-term cure rate and the long-term cure rate were not different between the two groups(all P > 0.05). The mild facial paralysis was seen in 1 case(1.49%) in monitoring group and in 13 cases(16.5%) in the control group. The hearing loss occurred in 4 cases(5.97%) in monitoring group and 18(22.8%) in the control group.The incidence of complications in the monitoring group was lower than that in the control group(all P < 0.05). The follow-up period was 6-12 months, with an average of 9.2 months. Facial paralysis and hearing loss were significantly improved in both groups.Conclusions According to the results of LSR monitoring, predicting the effect of decompression during MVD can improve the short-term cure rate, which is of great significance for the identification of responsible blood vessels and the protection of facial and auditory nerves, which can significantly reduce the incidence of complications such as facial paralysis and hearing loss.

关 键 词：面肌痉挛 显微血管减压术 神经电生理监测 侧方扩散反应 

分 类 号：R745.12[医药卫生—神经病学与精神病学]