显微血管减压术治疗面肌痉挛的经验总结及分析  

Analysis and summary of the experience in patients with hemifacial spasm treated by microvascular decompression

作　　者：王全才[1] 马逸[1] 黄海韬[1] 王斌[1] 周建波[1] 董经宇[1] 徐杨熙 李岩峰[1] Wang Quancai;Ma Yi;Huang Haitao;Wang Bin;Zhou Jianbo;Dong Jingyu;Xu Yangxi;Li Yanfeng(Department of Neurosurgery,The People’s Hospital of Liaoning Province,Shenyang 110013,China)

机构地区：[1]辽宁省人民医院神经外科,沈阳110013

出　　处：《中华脑科疾病与康复杂志（电子版）》2020年第4期244-247,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的总结分析显微血管减压术(MVD)治疗面肌痉挛(HFS)的手术经验。方法回顾性分析辽宁省人民医院神经外科自2017年1月至2018年12月收治的414例行MVD治疗HPS患者的临床资料,观察手术有效率及并发症的发生率。结果所有患者随访18~52个月,平均40.8个月,无死亡病例。术后即刻有效率为98.07%(406/414),并发症主要包括听力下降、耳鸣、头晕、迟发性面瘫及脑脊液瘘等,但多为一过性,术中责任血管多数为小脑后下动脉,其后是小脑前下动脉和椎动脉参与压迫;远期有效率为99.03%(410/414),远期并发症主要包括听力下降,耳聋及耳鸣等,暂无复发病例。结论MVD手术是一种安全、有效的治疗HPS方法,熟练的掌握MVD手术技巧、术中耐心细致的处理和术后谨慎防治并发症,奠定了一台MVD手术成功的基础。Objective To summarize and analyse the experience of microvascular decompression(MVD)in the treatment of hemifacial spasm(HPS).Methods Four hundred and fourteen patients with HFS,admitted by neurosurgery department of The People’s Hospital of Liaoning Province from January 2017 to December 2018,were analysesed retrospectively.All of the patients underwent MVD procedure.The efficiency and incidence of complication of postoperation were collected.Results The follow-up time ranged from 18 to 52 months in all patients(mean 40.8 months).There were no deaths.The instant efficiency was 98.07%(406/414).The postoperative complications mainly include hearing loss,tinnitus,vertigo,delayed facial paralysis and cerebrospinal fluid fistula,but most of them were transient.Most of the offending vessels were posterior inferior cerebellar artery,followed by anterior inferior cerebellar artery and vertebral artery.After follow-up,the long term efficiency was 99.03%(410/414).The long term complications mainly include hearing loss,total hearing loss and tinnitus.Up to date,there was no recurrent patient in this study.Conclusion MVD is a safe and effective method to treat HFS.Mastering the technology skillfully,manipulating properly during procedures and preventing from postoperative complications carefully lay the foundation for a successful MVD operation.

关 键 词：面肌痉挛 显微血管减压术 颅神经 

分 类 号：R651.3[医药卫生—外科学]