[1]张婧,宋启民,程彦昊,等.多模式神经电生理监测在面肌痉挛MVD中的应用[J].中国临床神经外科杂志,2024,29(01):19-21,24.[doi:10.13798/j.issn.1009-153X.2024.01.006]
　ZHANG Jing,SONG Qi-min,CHENG Yan-hao,et al.Application of multimodal neuroelectrophysiological monitoring in microvascular decompression for patients with hemifacial spasm[J].,2024,29(01):19-21,24.[doi:10.13798/j.issn.1009-153X.2024.01.006]
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多模式神经电生理监测在面肌痉挛MVD中的应用()
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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01期
页码:
19-21,24
栏目:
论著
出版日期:
2024-01-30

文章信息/Info

Title:
Application of multimodal neuroelectrophysiological monitoring in microvascular decompression for patients with hemifacial spasm
文章编号:
1009-153X（2024）01-0019-03
作者:
张婧; 宋启民; 程彦昊; 车峰远
264003山东烟台，滨州医学院第二临床医学院（张婧）；276034山东，临沂市人民医院神经外科（宋启民、程彦昊），神经生理学重点实验室（车峰远）
Author(s):
ZHANG Jing1;  SONG Qi-min2;  CHENG Yan-hao2;  CHE Feng-yuan3
1. The Second School ofClinical Medical, Binzhou Medical College, Yantai 264003, China; 2. Department of Neurosurgery, LinyiPeople's Hospital, Linyi 276034, China; 3. Key Laboratory of Neurophysiology, Linyi People's Hospital, Linyi 276034, China
关键词:
面肌痉挛; 显微血管减压术; 神经电生理监测; 疗效
Keywords:
Hemifacial spasm;  Microvascular decompression;  Abnormal muscle response;  Facial motor evoked potential;  Electromyography
分类号:
R 745.1+2; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2024.01.006
文献标志码:
A
摘要:
目的 探讨多模式神经电生理监测在面肌痉挛（HFS）显微血管减压术（MVD）中的应用效果。方法 回顾性分析2020年12月至2022年3月MVD治疗的80例HFS的临床资料。术中应用异常肌电反应（AMR）、面神经运动诱发电位（FMEP）及自由肌电图（EMG）监测指导手术。结果 术后1周治愈55例，明显缓解15例，部分缓解7例，无效3例；术后半年治愈57例，明显缓解10例，部分缓解9例，无效4例。术后1周治疗有效率为96.3%，术后半年治疗有效率为95.0%。术中AMR消失70例，存在10例；术中AMR消失病人术后1周（74.3%）、术后半年（78.6%）治愈率明显高于术中AMR存在的病人（分别为30.0%、20.0%；P<0.05）。80例术中均稳定引出FMEP，其中72例FMEP无变化；6例出现一过性波幅降低和（或）潜伏期延长，暂停手术操作后恢复；2例出现波幅降低且暂停手术操作无改善，术后出现面瘫。80例在分离和探查面神经REZ时均出现EMG不同程度的反应，其中一过性反应71例；持续出现的面神经爆发肌电图反应9例，暂停手术操作后缓解。结论 术中AMR +FMEP+EMG多模式电生理监测技术对MVD判断责任血管、提高治愈率、保护面神经功能及避免并发症具有重要作用。
Abstract:
Objective To investigate the application value of multi-mode neuroelectrophysiological monitoring in microvascular decompression (MVD) for patients with hemifacial spasm (HFS). Methods The clinical data of 80 patients with HFS treated by MVD from December 2020 to March 2022 were retrospectively analyzed. Abnormal muscle response (AMR), facial motor evoked potential (FMEP) and electromyography (EMG) were used to guide the operation. Results Of these 80 patients, 55 patients were cured, 15 were significantly relieved, 7 were partially relieved, and 3 were ineffective 1 week after operation; 57 patients were cured, 10 were significantly relieved, 9 were partially relieved, and 4 were ineffective 6 months after operation. The effective rates were 96.3% and 95.0 at 1 week and 6 months after operation, respectively. Intraoperative AMR was disappeared in 70 patients, and present in 10. The cure rate at 1 week (74.3%) and 6 months (78.6%) after operation of patients with intraoperative AMR disappearance were significantly higher than those (30.0% and 20.0%, respectively) of patients with intraoperative AMR presence (P<0.05). FMEP was successfully evoked in all 80 patients, of whom 72 patients had no change in FMEP, 6 had transient amplitude reduction and/or prolonged latency which recovered after stoping the operation, 2 had amplitude reduction and no improvement after stoping the operation, and had facial paralysis after operation. EMG responses were observed in all 80 patients during the separation and exploration of the root exit zone of facial nerve, including 71 patients with transient responses and 9 with persistent facial nerve burst EMG responses which were relieved after stoping the operation. Conclusions During MVD for patients with HFS, intraoperative multimodal electrophysiological monitoring technique of AMR+FMEP+EMG plays an important role in judging the responsible vessels of HFS, improving the cure rate, protecting facial nerve function and avoiding complications.

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备注/Memo

备注/Memo:
（2023-08-08收稿，2024-01-02修回） 基金项目：临沂市神经生理重点实验室项目（临科字[2015]57号） 通讯作者：宋启民，E-mail：songqimin-123@163.com 车峰远，E-mail：che1971@126.com
更新日期/Last Update: 2024-01-30