经小脑绒球入路与经脉络丛入路进行显微血管减压术治疗面肌痉挛疗效对比研究  

Comparative study on the effect of microvascular decompression through cerebellar flocculum and choroid plexus approach for hemifacial spasm

作　　者：别小华 薛俊刚 赵东升 韩超 邓国华 李超峰 王广杰 Bie Xiaohua;Xue Jungang;Zhao Dongsheng(Department of Neurosurgery,Xi'an Red Cross Hospital,Xi'an 710054,China)

机构地区：[1]西安市红会医院神经外科,710054

出　　处：《美中国际创伤杂志》2024年第3期3-6,47,共5页U.S.Chinese International Journal of Traumatology

摘　　要：目的:通过对比研究验证经脉络丛入路进行显微血管减压术治疗面肌痉挛的可行性。方法:面肌控挛患者分为A,B两组,A组481例患者采用传统的经小脑绒球入路行显微血管减压术,B组313例患者采用经脉络丛入路行显微血管减压术,记录患者的一般资料和随访1年记录治疗情况,以及并发症发生情况。结果:两组病例一般资料构成无明显差异,经脉络丛入路的病例比较经小脑绒球入路的病例治疗效果无明显差异,但经脉络丛入路行显微血管减压术的病例面听神经损伤发生较经小脑绒球入路病例有统计学差异,经脉络丛入路者有较少的面听神经损伤,而且经脉络丛入路病例有较少的共济失调和脑水肿发生,其他并发症两组比较无明显差异。结论:经脉络丛入路行显微血管减压术治疗面肌痉挛是一种治疗效果好,并发症更少的手术入路,值得推广。Objective:To verify the feasibility ofmicrovascular decompression surgery through the choroid plexus approach for the treatment of hemifacial spasm through a comparative study.Methods:Patients with hemifacial spasm were divided into groups A and B.481 patients in group A underwent microvascular decompression through the traditional cerebellar flocculus approach,and 313 patients in group B underwent microvascular decompression through the choroid plexus approach.The general data of the patients were recorded,and the treatment conditions and the occurrence of complications were recorded during the 1-year follow-up.Results:There was no significant difference in the composition of general data between the two groups.There was no significant diference in the treatment effect between the cases through the choroid plexus approach and those through the cerebellar flocculus approach.However,there was a statistically significant difference in the occurrence of facial acoustic nerve injury between the cases through the choroid plexus approach for microvascular decompression and those through the cerebellar flocculus approach.There were fewer facial acoustic nerve injuries in the cases through the choroid plexus approach,and there were fewer cases of ataxia and cerebral edema in the cases through the choroid plexus approach.There was no significant difference in other complications between the two groups.Conclusion:Microvascular decompression through the choroid plexus approach for the treatment of hemifacial spasm is a surgical approach with good therapeutic effect and fewer complications,and it is worthy of promotion.

关 键 词：面肌痉挛 显微血管减压术 小脑绒球 脉络丛 

分 类 号：R74[医药卫生—神经病学与精神病学]