[1]申彦杰,程东亮,成文平,等.面肌痉挛显微血管减压术治疗分析[J].中国临床神经外科杂志,2024,29(09):537-540.[doi:10.13798/j.issn.1009-153X.2024.09.006]
　SHEN Yan-jie,CHENG Dong-liang,CHENG Wen-ping,et al.Microvascular decompression for patients with facial spasm: a report of 187 cases and literature review[J].,2024,29(09):537-540.[doi:10.13798/j.issn.1009-153X.2024.09.006]
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面肌痉挛显微血管减压术治疗分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年09期
页码:
537-540
栏目:
论著
出版日期:
2024-09-30

文章信息/Info

Title:
Microvascular decompression for patients with facial spasm: a report of 187 cases and literature review
文章编号:
1009-153X（2024）09-0537-04
作者:
申彦杰; 程东亮; 成文平; 任瑞明; 张坤
455000 河南，安阳市第六人民医院神经外科（申彦杰、程东亮、成文平、任瑞明、张　坤）
Author(s):
SHEN Yan-jie;  CHENG Dong-liang;  CHENG Wen-ping;  REN Rui-ming;  ZHANG Kun
Department of Neurosurgery, The Sixth People's Hospital of Anyang City, Anyang 455000, China
关键词:
面肌痉挛; 显微血管减压术; 疗效
Keywords:
Facial spasm;  Microvascular decompression;  Efficacy
分类号:
R 745.1+2; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2024.09.006
文献标志码:
A
摘要:
目的 探讨显微血管减压术治疗面肌痉挛的手术方法及其临床疗效。方法 回顾性分析2018年1月至2022年7月显微血管减压术治疗的187例面肌痉挛的临床资料。结果 术中发现责任血管的构成：小脑前下动脉81例（43.3%），小脑后下动脉39例（20.9%），多根血管同时压迫67例（35.8%）。178例（95.2%）术后即刻症状完全消失，9例（4.8%）术后2周至3个月逐步消失。3例术后出现耳鸣，1个月后逐步恢复；1例出现听力丧失，未恢复；8例出现轻度面瘫，应用神经营养药物及结合局部针灸、高压氧治疗恢复；3例出现中度发热，静脉应用地塞米松3~5 d体温恢复正常；1例出现伤口脑脊液漏，经局部加压包扎等保守治疗愈合。术后无颅内感染、脑内出血等并发症，无手术死亡。结论 显微血管减压术是治疗面肌痉挛的一种技术成熟的手术方法，术中熟练的显微外科操作，分清责任血管，做好术中监测，避免过分牵拉，是提高治愈率、减少并发症的关键。
Abstract:
Objective To explore the surgical methods and clinical efficacy of microvascular decompression for patients with facial spasm. Methods The clinical data of 187 patients with hemifacial spasm treated by microvascular decompression from January 2018 to July 2022 were retrospectively analyzed. Results The anterior inferior cerebellar artery was identified as the responsible vessels during the operation in 81 patients (43.3%), the posterior inferior cerebellar artery in 39 (20.9%), and multiple vessels in 67 (35.8%). Of these 187 patients, 178 patients (95.2%) had complete disappearance of symptoms immediately after the operation, and 9 (4.8%) had gradual disappearance within 2 weeks to 3 months after the operation. Three patients developed tinnitus after the operation and gradually recovered after one month; 1 had hearing loss and did not recover; 8 had mild facial paralysis and recovered after treatment with neurotrophic drugs combined with local acupuncture and hyperbaric oxygen therapy; 3 had moderate fever, and the body temperature returned to normal after 3 to 5 days of intravenous dexamethasone administration; 1 had cerebrospinal fluid leakage from the wound and healed after conservative treatment such as local pressure dressing. There were no complications such as intracranial infection and intracerebral hemorrhage after the operation, and no surgical deaths occurred. Conclusion Microvascular decompression is a mature surgical method for the treatment of hemifacial spasm. Skilled microsurgical operation during the operation, identification of the responsible vessels, and good intraoperative monitoring to avoid excessive traction are the keys to improving the cure rate and reducing complications.

参考文献/References:

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备注/Memo

备注/Memo:
（2023-07-02收稿，2024-05-30修回）
更新日期/Last Update: 2024-09-30