神经电生理检查在特发性面神经麻痹患者中的应用  

Application of neuroelectrophysiological examination in patients with idiopathic facial paralysis

作　　者：张立霞[1] Zhang Lixia(Department of Electrophysiology,Weifang Hospital of Traditional Chinese Medicine,Weifang City,Shandong Province,262100,China)

机构地区：[1]潍坊市中医院电生理室,山东省潍坊市262100

出　　处：《现代电生理学杂志》2024年第1期33-36,共4页Journal of Modern Electrophysiology

摘　　要：目的探讨神经电生理检查在评估特发性面神经麻痹患者病情及预后方面的应用价值。方法收集潍坊市中医院脑病科2022年1月至2022年12月收治的50例特发性面神经麻痹患者为研究对象,年龄(52.9±16.8)岁,其中男20例,女30例,左侧面瘫28例,右侧面瘫22例。对所有患者进行神经电生理检查,包括瞬目反射、运动神经传导、针电极肌电图等。发病始(3~5 d)、3个月、6个月分别进行House-Brackmann(H-B)评分,评价电生理指标对病情严重程度评估及预后的判断价值。结果患侧与健侧R1、R2及R2’潜伏期差异具有统计学意义(P<0.05)。瞬目反射的异常率为90%,M波波幅异常率92%,针极肌电图异常率为80%。神经电生理与H-B量表判断患者严重程度的一致性好(Kappa=0.592)。电生理病情分度轻度者多数在3个月内痊愈,中度或重度者痊愈时间可达6个月及以上,甚至难以痊愈。结论神经电生理检查在诊断特发性面神经麻痹中具有重要价值,可有效评估患者病情程度及预后。Objective To explore the application value of neuroelectrophysiological examination in evaluating the condition and prognosis of patients with idiopathic facial paralysis.Methods Fifty patients with idiopathic facial paralysis,aged(52.9±16.8)years old,20 males and 30 females,28 left side facial palsy and 22 right side facial palsy,who were admitted to Weifang Hospital of Traditional Chinese Medicine from January 2022 to December 2022,were collected as the study objects.Neuroelectrophysiological examination including blink reflex,motor nerve conduction,needle electromyography was performed in all patients.Home Brackmann(H-B)scores were performed at the beginning of the disease(3-5 days),3 months and 6 months respectively to evaluate the value of electrophysiological indicators in evaluating the severity of the disease and prognosis.Results There was a statistically significant difference in the latency of R1,R2,and R2'between the affected and healthy sides(P<0.05).The abnormal rates of blink reflection,M wave amplitude and needle EMG were 90%,92%and 80%respectively.Neuroelectrophysiology and H-B scale showed good consistency in judging the severity of patients(Kappa=0.592).Patients with mild electrophysiological grading mostly recovered within 3 months,and the recovery time of moderate or severe patients could reach 6 months or more,or even difficult to recover.Conclusion Neuroelectrophysiological examination has important value in the diagnosis of idiopathic facial paralysis,and can effectively evaluate the severity and prognosis of patients.

关 键 词：电生理学 面神经麻痹 诊断 预后 

分 类 号：R745.12[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]