面神经显微血管减压术中困难减压的处理措施及其效果  

Treatment measures of difficult decompression during facial nerve microvascular decompression and its effect

作　　者：钟建卫 李煜环[1] 黄瑞景 孙永锋[1] 石磊 王涛[1] ZHONG Jianwei;LI Yuhuan;HUANG Ruijing;SUN Yongfeng;SHI Lei;WANG Tao(Department of Military Medicine and Special Disciplines,Beijing Municipal Corps Hospital of Chinese People’s Armed Police Force,Beijing 100027,China)

机构地区：[1]武警北京总队医院军事医学与特种学科,100027

出　　处：《武警医学》2024年第12期1032-1035,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的 探讨面神经显微血管减压手术中困难减压的处理措施及其效果。方法 回顾性分析2019-01至2023-10在武警北京总队医院行面神经显微血管减压术中31例困难减压患者的临床资料,对于术中脑膨出、蛛网膜严重粘连、复杂责任血管等困难减压类型,进行针对性处理并观察其手术效果。结果 本组20例(66.66%)面肌痉挛症状完全消失,属于完全缓解;7例(22.58%)仍有程度不同的面肌痉挛症状,属于部分缓解;4例(13.33%)症状无变化。随访6个月后,3例仍存在轻度的面部抽动,较术前明显缓解,总体治愈率为90.33%。结论 对于面神经显微血管减压术出现困难减压的情况,可以通过术前细致的评估、术中灵活多样的困难减压应对处理措施,同样可以获得较好的手术疗效。Objective To investigate the treatment measures of difficult decompression in facial nerve microvascular decompression and its effect.Methods The clinical data of 31 patients with difficult decompression who underwent facial nerve microvascular decompression in Beijing Municipal Corps Hospital of Chinese People’s Armed Police Force from January 2019 to October 2023 were retrospectively analyzed.The types of difficult decompression such as intraoperative encephalocele,severe arachnoid adhesions and complex responsible blood vessels,were targeted and the surgical effects were observed.Results The symptoms of hemifacial spasm disappeared completely in 20 patients(66.66%),which was a complete remission.Seven patients(22.58%)still had facial spasm symptoms of varying degrees,which were partially relieved.Four cases(13.33%)had no change in symptoms.After 6 months of follow-up,3 patients still had mild facial tics,which was significantly relieved than before surgery,and the overall cure rate was 90.33%.Conclusions In the case of difficult decompression during facial nerve microvascular decompression,a good surgical effect can be obtained through careful preoperative evaluation and flexible and diverse intraoperative difficult decompression measures.

关 键 词：面肌痉挛 显微血管减压 困难减压 处理措施 

分 类 号：R745.1[医药卫生—神经病学与精神病学]