面神经显微血管减压术对中重度面肌痉挛疗效及延迟治愈影响因素分析  

Efficacy of Microvascular Decompression for Moderate to Severe Hemifacial Spasm and the Influencing Factors of Delayed Resolution

作　　者：王坤 蒲军[2] 李东波[1] 杨涛[1] WANG Kun;PU Jun;LI Dongbo;YANG Tao(Dept.of Neurosurgery,Ankang Central Hospital,Ankang Shaanxi 725000;Dept.of Neurosurgery,The 2nd Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101,China)

机构地区：[1]安康市中心医院神经外科,陕西安康725000 [2]昆明医科大学第二附属医院神经外科,云南昆明650101

出　　处：《昆明医科大学学报》2024年第10期50-54,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(82160512)。

摘　　要：目的探讨面神经显微血管减压术对中重度面肌痉挛疗效及延迟治愈的相关影响因素。方法选取安康市中心医院神经外科收治的2018年5月至2023年5月接受面神经显微血管减压术治疗的中重度面肌痉挛患者60例。观察患者临床疗效、术后并发症,并根据临床疗效将其分为立即治愈组与延迟治愈组,利用多因素Logistic回归分析患者延迟治愈的影响因素。结果60例患者中,立即治愈47例、延迟治愈13例,术后发生感染2例、听觉障碍2例、低颅压综合征1例、面瘫2例,并发症发生率为11.67%。立即治愈组与延迟治愈组病程、长期口服卡马西平、症状严重程度、注射肉毒素、血管压迫程度相比,差异有统计学意义(P<0.05)。Logistics回归分析显示,症状严重程度、病程、血管压迫程度是延迟治愈的影响因素。结论病程、症状严重程度、血管压迫程度是中重度面部痉挛患者接受面神经显微血管减压术延迟治愈的影响因素,临床应密切监测以上指标并采取相应措施,使患者预后改善,生活质量提高。Objective To investigate the clinical efficacy of microvascular decompression for moderate-tosevere hemifacial spasm and the influencing factors of delayed resolution.Methods Sixty patients with moderate-tosevere hemifacial spasm who underwent microvascular decompression at the Neurosurgery Department of Ankang Central hospital from May 2018 to May 2023 were selected.Then the clinical efficacy and postoperative complications were were studied,and they were categorized into an immediate cure group and a delayed cure group based on clinical outcomes.Multivariate logistic regression analysis was used to determine the factors affecting delayed recovery in patients.Results Among the 60 patients,47 were cured immediately,while 13 were cured later.There were 2 cases of infection,2 cases of hearing impairment,1 case of low cerebrospinal fluid pressure syndrome,and 2 cases of facial paralysis after the procedure,resulting in a complication rate of 11.67%.There were statistically significant differences(P<0.05)in the duration of illness,long-term use of carbamazepine,severity of symptoms,injections of Botox,and degree of vascular compression between the immediate cure group and the delayed cure group.Logistic regression analysis indicated that severity of symptoms,duration of illness,and degree of vascular compression are factors influencing delayed cure.Conclusion The course of the disease,severity of symptoms,and degree of intraoperative vascular compression are influencing factors for delayed recovery in patients with moderate-to-severe hemifacial spasm undergoing microvascular decompression of the facial nerve.Clinically,it's important to closely monitor these indicators and take appropriate measures to improve the prognosis and quality of life for patients.

关 键 词：显微血管减压术 面肌痉挛 临床疗效 延迟治愈 影响因素 

分 类 号：R745.12[医药卫生—神经病学与精神病学]