[1]李　珂　杨小朋　董　军等.侧方扩散反应监测在面肌痉挛微血管减压术中的应用[J].中国临床神经外科杂志,2021,26(12):915-917.[doi:10.13798/j.issn.1009-153X.2021.12.006]
　LI Ke,YANG Xiao-peng,DONG Jun,et al.Application of lateral spread response monitoring in microvascular decompression for patients with primary hemifacial spasm[J].,2021,26(12):915-917.[doi:10.13798/j.issn.1009-153X.2021.12.006]
点击复制

侧方扩散反应监测在面肌痉挛微血管减压术中的应用()

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年12期
页码:
915-917
栏目:
论著
出版日期:
2021-12-25

文章信息/Info

Title:
Application of lateral spread response monitoring in microvascular decompression for patients with primary hemifacial spasm
文章编号:
1009-153X（2021）12-0915-03
作者:
李　珂　杨小朋　董　军等
832000 新疆石河子，石河子大学医学院研究生院（李　珂、潘　淼）；830001 乌鲁木齐，新疆维吾尔自治区人民医院神经外科（董　军、高　峰、孙连杰、杨小朋）
Author(s):
LI Ke1;  YANG Xiao-peng2;  DONG Jun2;  GAO Feng2;  SUN Lian-jie2;  PAN Miao1.
1. Postgraduate School, School of Medicine, Shihezi University, Shihezi 832000, China; 2. Department of Neurosurgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
关键词:
面肌痉挛; 微血管减压术; 侧方扩散反应; 疗效
Keywords:
Hemifacial spasm;  Microvascular decompression;  Lateral spread response;  Curative effect
分类号:
R 745.1+2; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2021.12.006
文献标志码:
A
摘要:
目的 探讨侧方扩散反应（LSR）监测在面肌痉挛（HFS）微血管减压术（MVD）中的应用价值。方法 回顾性分析2016年6月至2018年8月MVD治疗的70例HFS的临床资料，术中均监测LSR。术后1周、1年根据Cohen分级评估术后疗效，0级为治愈。结果 70例均监测到LSR，其中LSR消失65例（消失组），确认充分减压后LSR仍持续存在5例（未消失组）。术后1周，消失组治愈率[92.3%（60/65）]明显高于未消失组[40.0%（2/5）；P<0.05]。术后1年，消失组治愈[96.9%（63/65）与未消失组[80.0%（4/5）]无统计学差异（P>0.05）。结论 MVD治疗HFS，术中监测LSR可以帮助确定责任血管，尽可能减少责任血管的遗漏；术中LSR消失提示近期疗效较好，但对长期疗效的预测价值有限。
Abstract:
Objective To investigate the value of lateral spread response (LSR) monitoring in microvascular decompression (MVD) for the patients with primary hemifacial spasm (pHFS). Methods The clinical data of 70 patients with pHFS who underwent MVD under guidance of LSR monitoring from June 2016 to August 2018 were analyzed retrospectively. One week and one year after the operation, the effectiveness was evaluated according to the Cohen classification and the patients with Cohen level 0 were cured. Results LSR was detected in all the patients. The LSR was disappeared in 65 patients during the operation (disappeared group) and did not in 5 patients (non-disappeared group). One week after the operation, the cured rate of the disappeared group [92.3% (60/65)] was significantly higher than that [40.0% (2/5)] of the non-disappeared group (P<0.05). One year after the operation, there was no statistical difference in the cured rate between the disappeared group [96.9% (63/65)] and the non-disappeared group [80.0% (4/5); P>0.05]. Conclusions For the patients with HFS undergoning MVD, intraoperative LSR monitoring can help determine the responsible vessels and minimize the omission of responsible vessels. The disappearance of intraoperative LSR indicates that the short-term efficacy is better, but its predictive value of the long-term efficacy is limited.

参考文献/References:

[1] Bekar A, Kuytu T, Turkkan A, et al. The efficacy and safety of microvascular decompression for hemifacial spasm: a retrospective analysis of surgical outcomes and complica-tions [J]. Turkish Neurosurg, 2020, 30(2): 231-236.
[2] Song H, Xu S, Fan X, et al. Prognostic value of lateral spreadresponse during microvascular decompression for hemi-facial spasm [J]. J Int Med Res, 2019, 47(12): 6120-6128.
[3] 邓予慧，杨　洁，柴永川，等. 双镜联合在治疗面肌痉挛微血管减压术中的临床应用[J]. 中华耳鼻咽喉头颈外科杂志，2019，26（4）：267-271.
[4] Thirumala PD, Altibi AM, Chang R, et al. The utility of intraoperative lateral spread recording in microvascular decompression for hemifacial spasm: a systematic review and meta-analysis [J]. Neurosurgery, 2020, 87(4): E473-E484.
[5] Yamashita S, Kawaguchi T, Fukuda M, et al. Lateral spread response elicited by double stimulation in patients with hemifacial spasm [J]. Muscle Nerve, 2002, 25(6): 845-849.
[6] 贾　力，傅先明，姜晓峰，等. 神经电生理监测异常肌反应在面肌痉挛术中的作用[J]. 中国临床神经外科杂志，2015，20（5）：262-264.
[7] Lee SH, Park BJ, Shin HS, et al. Prognostic ability of intra operative electromyographic monitoring during microvas-cular decompression for hemifacial spasm to predict lateral spread response outcome [J]. J Neurosurg, 2017, 126(2): 391-396.
[8] Wei Y, Yang W, Zhao W, et al. Microvascular decompres-sion for hemifacial spasm: can intra- operative lateral spread response monitoring improve surgical efficacy [J]. J Neurosurg, 2018, 128: 885-889.
[9] Zhang J, Li Z, Wang J, et al. Prognostic value of abnormal muscle response during microvascular decompression for hemifacial spasm: a meta-analysis [J]. World Neurosurg, 2020, 137: 8-17.
[10] 姜成荣，王　晶，徐　武，等. 面肌痉挛显微血管减压术中异常肌反应提前消失的研究[J]. 中华神经外科杂志，2017，33（4）：372-376.
[11] 梁韡斌，毛　珂，韦可聪，等. 后颅窝空间大小与面肌痉挛发生的相关性[J]. 中华神经科杂志，2015，48：984-986.
[12] Kim CH, Kong DS, Lee JA, et al. The potential value of the disappearance of the lateral spread response during micro-vascular decompression for predicting the clinical outcome of hemifacial spasms: a prospective study [J]. Neurosurgery, 2010, 67(6): 1587-1588.
[13] 董　军，伊小军，高　峰，等. 侧方扩散反应电位监测在面神经显微血管减压术的意义[J]. 中国微侵袭神经外科杂志，2018，23（5）：228-229.
[14] Terasaka S, Asaokal K, Yamaguchi S，et al. A significant correlation between delayed cure after microvascular de-compression and positive response to preoperative anticon-vulsant therapy in patients with hemifacial spasm [J]．Neurosurg Rev, 2016, 39(4): 607-613.
[15] Zhang P, Selim MH, Wang H, et al. Intraoperative measu-ring of the offending vessel’s pressure on the facial nerve at root exit zone in patients with hemifacial spasm during microvascular decompression: a prospective study [J]. WorldNeurosurg, 2019, 122: e89-e95.

相似文献/References:

[1]宋　健　刘　敏　丁慧超　杜　浩　向伟楚　黄　成　黄　河　孙荣辉　何远志　徐国政　马廉亭.术前MRI与Dyna-CTA三维影像融合对微血管减压术难易程度的评估价值[J].中国临床神经外科杂志,2015,(10):597.[doi:10.13798/j.issn.1009-153X.2015.10.007]
　SONG Jian,LIU Min,DING Hui-chao,et al.Value of preoperative MRI and Dyna-CTA 3D-imaging fusion to microvascular decompression[J].,2015,(12):597.[doi:10.13798/j.issn.1009-153X.2015.10.007]
[2]吴广源　尹　卫　郑思阳　齐　辉.自体颅骨碎屑一期修复颅神经微血管减压术骨窗的临床观察[J].中国临床神经外科杂志,2015,(06):364.[doi:10.13798/j.issn.1009-153X.2015.06.016]
[3]荣道建　何　颖　杨晓健　赵　骞　赵俊伟　杨　峰.三维时间飞跃法磁共振血管成像在原发性三叉神经痛诊治中的临床价值[J].中国临床神经外科杂志,2015,(04):241.[doi:10.13798/j.issn.1009-153X.2015.04.018]
[4]佘苏华　邓兴力　李　杨　王　波　任仲坤　沈　勇　杨智勇　李　玉.微血管减压术治疗桥小脑角区颅神经压迫综合征的疗效分析[J].中国临床神经外科杂志,2015,(01):18.[doi:10.13798/j.issn.1009-153X.2015.01.006]
　SHE Su-hua,DENG Xing-li,LI Yang,et al.Microvascular decompression surgery for cranial nerve compression syndrome (report of 232 cases)[J].,2015,(12):18.[doi:10.13798/j.issn.1009-153X.2015.01.006]
[5]何少宇,李　玉,李　杨,等.原发性三叉神经痛微血管减压术中岩静脉的处理[J].中国临床神经外科杂志,2016,(12):747.[doi:10.13798/j.issn.1009-153X.2016.12.005]
　HE Shao-yu,LI Yu,LI Yang,et al.Management of petrosal vein in microvascular decompression for primary trigeminal neuralgia[J].,2016,(12):747.[doi:10.13798/j.issn.1009-153X.2016.12.005]
[6]耿亮,王义宝,王占福.微血管减压术治疗原发性三叉神经痛126例[J].中国临床神经外科杂志,2017,(02):95.[doi:10.13798/j.issn.1009-153X.2017.02.011]
[7]余海林　宋业纯　王晓松.单纯表现为面肌痉挛的桥小脑角区胶样囊肿1例[J].中国临床神经外科杂志,2017,(03):138.[doi:10.13798/j.issn.1009-153X.2017.03.003]
[8]罗　波 范润金 张　逵 尚　彬 刘　毅 唐晓平.全程围套式微血管减压术治疗原发性三叉神经痛的临床分析[J].中国临床神经外科杂志,2017,(10):687.[doi:10.13792017.09/j.issn.1009-153X.2017.10.005]
　LUO Bo,FAN Rui-jin,ZHANG Kui,et al.Clinical analysis of the treatment of primary trigeminal neuralgia by whole-range encircling method of microvascular decompression[J].,2017,(12):687.[doi:10.13792017.09/j.issn.1009-153X.2017.10.005]
[9]陈姣红　张红波　熊晓星.三叉神经痛微血管减压术后疼痛观察及护理[J].中国临床神经外科杂志,2017,(12):854.[doi:10.13798/j.issn.1009-153X.2017.12.019]
[10]郑　玺.微血管减压术治疗原发性三叉神经痛65例[J].中国临床神经外科杂志,2018,(06):429.[doi:10.13798/j.issn.1009-153X.2018.06.016]
[11]杜　浩　黄　河　宋　健　何远志　孙荣辉　丁慧超　姚　顺　徐国政.面肌痉挛微血管减压术后并发症的相关危险因素分析[J].中国临床神经外科杂志,2016,(05):267.[doi:10.13798/j.issn.1009-153X.2016.05.004]
　DU Hao,HUANG He,SONG Jian,et al.Analysis of risk factors related to complications after microvascular decompression in patients with hemifacial spasm[J].,2016,(12):267.[doi:10.13798/j.issn.1009-153X.2016.05.004]
[12]申彦杰　宋　健　成文平　程东亮.微血管减压术治疗面肌痉挛57例[J].中国临床神经外科杂志,2016,(04):238.[doi:10.13798/j.issn.1009-153X.2016.04.016]
[13]黄　进　吴祥奎　张岩松　邵君飞.肌电图监测在面肌痉挛微血管减压术中的应用[J].中国临床神经外科杂志,2016,(03):164.[doi:10.13798/j.issn.1009-153X.2016.03.011]
　HUANG Jin,WU Xiang-kui,ZHANG Yan-song,et al.Application of EMG monitoring to microvascular decompression for hemifacial spasm[J].,2016,(12):164.[doi:10.13798/j.issn.1009-153X.2016.03.011]
[14]曾　冉　王飞红　袁邦清　杨　光　苏同刚.微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2016,(03):175.[doi:10.13798/j.issn.1009-153X.2016.03.016]
[15]向兴刚　张永辉　李大志　昝向阳　于晓晨　蔡　宁　赵　永　林　琳.神经内镜辅助微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2015,(10):624.[doi:10.13798/j.issn.1009-153X.2015.10.015]
[16]卫永旭　杨文磊　赵卫国　李　宁　蔡　瑜　濮春华　吴哲褒.肌松药对面肌痉挛微血管减压术中电生理监测的影响[J].中国临床神经外科杂志,2015,(09):526.[doi:10.13798/j.issn.1009-153X.2015.09.005]
　WEI Yong-xu,YANG Wen-lei,ZHAO Wei-guo,et al.Effect of muscle relaxants on lateral spread responses during microvascular decompression for hemifacial spasm[J].,2015,(12):526.[doi:10.13798/j.issn.1009-153X.2015.09.005]
[17]耿　飞.枕下乙状窦后入路微血管减压治疗面肌痉挛的并发症及处理[J].中国临床神经外科杂志,2015,(03):168.[doi:10.13798/j.issn.1009-153X.2015.03.014]
[18]贾　力　傅先明　姜晓峰　牛朝诗　邓大丽　何金超　李仲森　汪业汉.神经电生理监测异常肌反应在面肌痉挛术中的作用[J].中国临床神经外科杂志,2015,(05):262.[doi:10.13798/j.issn.1009-153X.2015.05.002]
　JIA Li,FU Xian-ming,JIANG Xiao-feng,et al.Use of intraoperative electrophysiological monitoring of abnormal muscle response in surgery for hemifacial spasm[J].,2015,(12):262.[doi:10.13798/j.issn.1009-153X.2015.05.002]
[19]王　宁　王　林　陈国强　黄乙洋　焦永辉　郭宇鹏　王晓松.以三叉神经痛和/或面肌痉挛起病的桥小脑角区肿瘤的手术治疗[J].中国临床神经外科杂志,2017,(08):549.[doi:10.13798/j.issn.1009-153X.2017.08.009]
　WANG Ning,WANG Lin,CHEN Guo-qiang,et al.Microsurgery via suboccipital retrosigmoid approach for cerebellopontine angle tumors with onset of trigeminal neuralgia and hemifacial spasm[J].,2017,(12):549.[doi:10.13798/j.issn.1009-153X.2017.08.009]
[20]丁胜超　贺　峰　贾继明.椎-基底动脉扩张延长症致面肌痉挛的手术治疗[J].中国临床神经外科杂志,2018,(05):308.[doi:10.13798/j.issn.1009-153X.2018.05.002]
　DING Sheng-chao,HE Feng,JIA Ji-ming..Surgical treatment of hemifacial spasm caused by vertebrobasilar dolichoectasia[J].,2018,(12):308.[doi:10.13798/j.issn.1009-153X.2018.05.002]

备注/Memo

备注/Memo:
通讯作者：杨小朋，E-mail：13709912028@139.com
更新日期/Last Update: 1900-01-01