面神经电图联合瞬目反射对特发性面神经炎的预后评估  

Prognostic Evaluation of Idiopathic Facial Neuritis Using Facial Electroencephalogram Combined With Blink Reflex

作　　者：杜雨欣 肖黎黎 刘春霞 张弟文[1] 王丽波 DU Yuxin;XIAO Lili;LIU Chunxia;ZHANG Diwen;WANG Libo(Department of Neurology,Sichuan Mental Health Center/the Third Hospital of Mianyang,Mianyang Sichuan 621000,China)

机构地区：[1]四川省精神卫生中心/绵阳市第三人民医院神经内科,四川绵阳621000

出　　处：《中国卫生标准管理》2024年第13期99-102,共4页China Health Standard Management

基　　金：绵阳市第三人民医院2021年度科研立项课题(202118)。

摘　　要：目的通过计算面神经颞支传导和瞬目反射R1波的商来判断特发性面神经炎的预后。方法选取2022年5—12月四川省精神卫生中心/绵阳市第三人民医院神经内科收治的80例单侧周围性面神经炎患者,均完成面神经传导和瞬目反射检查,纳入瞬目反射出波者55例为研究对象。计算BR瞬目反射(blink reflex,BR)中R1波的潜伏期与面神经颞支运动传导潜伏期(DR)的商(R1/DR),比较治疗前后潜伏期及波幅的变化。同时进行面神经House-Brackmann分级评分。结果治疗后2组均在15 d时较在7 d时面神经颞支运动传导潜伏期缩短(P<0.05);2组面神经颞支运动传导波幅在15 d和7 d比较,波幅升高(P<0.05),且B组潜伏期缩短、波幅升高的百分比大于A组(P<0.05)。针电极记录A组和B组眼轮匝肌运动传导潜伏期,2组经治疗后在15 d时较在7 d时潜伏期缩短(P<0.05);波幅在15 d和7 d比较,波幅升高(P<0.05),且B组潜伏期缩短、波幅升高的百分比大于A组(P<0.05)。A组平均面神经H-B评为(3.68±1.30)分,B组为(3.28±1.07)分,B组的HB评分比A组更低(t=3.320,P=0.028)。结论面神经末梢性损害比根性损害恢复好,可将R1/DR作为评估面神经预后的指标。Objective To predicte the prognosis of idiopathic facial neuritis by calculating the quotient of R1 waves of facial nerve temporal branch conduction and blink reflex.Methods A total of 80 patients with unilateral peripheral facial neuritis admitted from May to December 2022 at Sichuan Mental Health Center/the Third Hospital of Mianyang were screened,all of whom completed facial nerve conduction and blink reflex examination,and 55 patients with blink reflex wave were included as study objects.The quotient(R1/DR)between the latency of R1 in BR and the motor conduction latency(DR)of the temporal branch of facial nerve was calculated,and the changes of latency and amplitude before and after treatment were compared.At the same time,facial nerve House-Brackmann grading was performed.Results After treatment,the motor conduction latency of temporal branch of facial nerve in both groups was shorter at day 15 than at day 7(P<0.05).The motion conduction amplitude of the temporal branch of facial nerve in 2 groups was higher at day 15 than at day 7(P<0.05).The percentage of shortened latency and increased amplitude in group B was higher than that in group A(P<0.05).The motor conduction latency of orbicularis oculi in group A and group B was recorded by needle electrode.After treatment,the incubation period of 2 groups was shorter at day 15 than at day 7(P<0.05).Compared with day 15 and day 7,the amplitude of the wave increased(P<0.05).The percentage of shortened latency and increased amplitude in group B was higher than that in group A(P<0.05).The average H-B score of facial nerve in group A was(3.68±1.30),and that in group B was(3.28±1.07),and HB score in group B was lower than that in group A(t=3.320,P=0.028).Conclusion The prognosis of facial nerve can be evaluated by the quotient(R1/DR)between the latency of R1 in BR and the motor conduction latency(DR)of the temporal branch of facial nerve.

关 键 词：特发性面神经炎 面神经电图 瞬目反射 面神经颞支运动传导 潜伏期 预后 

分 类 号：R745[医药卫生—神经病学与精神病学]