平卧位耳后小切口手术入路微血管减压术治疗面肌痉挛患者的效果  

Effects of Microvascular Decompression with Small Incision Behind Ear in Patients with Hemifacial Spasm in Supine Position

作　　者：陈成 刘华 刘博 袁浩 CHEN Cheng;LIU Hua;LIU Bo;YUAN Hao(Neurosurgery Department,the 989th Hospital of the People’s Liberation Army Joint Logistics Support Force,Luoyang 471000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院神经外科,河南洛阳471000

出　　处：《河南医学研究》2023年第21期3937-3940,共4页Henan Medical Research

摘　　要：目的探究不同入路微血管减压术治疗面肌痉挛的疗效及分析术后并发症。方法前瞻性选取2019年10月至2022年10月中国人民解放军联勤保障部队第九八九医院收治的102例面肌痉挛患者为研究对象,按随机数表法将患者分为研究组(51例)与对照组(51例)。对照组接受传统侧卧位乙状窦后直切口入路,研究组接受平卧位耳后小切口手术入路。比较两组手术相关指标、疗效与并发症发生情况。结果两组住院时间比较,差异无统计学意义(P>0.05),但研究组术前准备时间、麻醉时间、手术时间均短于对照组(P<0.05)。两组间术后1 d、3个月、6个月总有效率相比,差异无统计学意义(P>0.05)。两组术后并发症发生率(33.33%)低于对照组(49.02%),且研究组躯干皮肤发生率、头皮(头钉)发生率、颈肩部疼痛发生率与复发率均低于对照组(P<0.05)。结论传统侧卧位乙状窦后直切口入路与平卧位耳后小切口手术入路微血管减压术治疗面肌痉挛效果均较好,但后者可有效减少术前准备时间与手术时间,并降低体位相关并发症与术后并发症发生率。Objective To explore the efficacy of microvascular decompression through different approaches for treating facial spasm and analyze postoperative complications.Methods A prospective study was conducted on 102 patients with facial spasm admitted to the 989th Hospital of the People’s Liberation Army Joint Logistics Support Force from October 2019 to October 2022.The patients were divided into a study group(51 patients)and a control group(51 patients)using random number table method.The control group was treated with the traditional lateral position straight posterior sigmoid sinus approach,while the study group was treated with the supine position small posterior ear incision approach.The differences in surgical related indicators,efficacy,and complications were compared between the two groups.Results There was no difference in hospital stay between the two groups(P>0.05),but the study group had lower preoperative preparation time,anesthesia time,and surgical time than the control group(P<0.05).There were no differences between the two groups in 1-day,3-month and 6-month postoperative total efficacy(P>0.05).The postoperative complications in the study group(33.33%)were lower than those in the control group(49.02%),and the incidence of trunk skin,scalp(head nail),neck and shoulder pain,and recurrence in the study group were lower than those in the control group(P<0.05).Conclusion Both the traditional lateral and lateral lateral straight posterior sigmoid incision approach and the supine microvascular decompression approach with small incision behind the ear have good efficacy in the treatment of hemifacial spasm,but the latter can effectively reduce the preoperative preparation time and operation time,and reduce the incidence of postural and postoperative complications.

关 键 词：面肌痉挛 传统侧卧位乙状窦后直切口入路 平卧位耳后小切口手术入路 

分 类 号：R651.3[医药卫生—外科学]