[1]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):164-166.[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,(03):164-166.[doi:10.13798/j.issn.1009-153X.2016.03.011]
点击复制

肌电图监测在面肌痉挛微血管减压术中的应用()
分享到：

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

卷:
期数:
2016年03期
页码:
164-166
栏目:
论著
出版日期:
2016-03-25

文章信息/Info

Title:
Application of EMG monitoring to microvascular decompression for hemifacial spasm
文章编号:
1009-153X（2016）03-0164-03
作者:
黄　进　吴祥奎　张岩松　邵君飞
212000 江苏，镇江市第一人民医院神经外科（黄　进）;
710400 陕西，周至县人民医院神经外科（吴祥奎）;
210000 南京，南京医科大学附属南京脑科医院神经外科（张岩松）;
214023 江苏无锡，南京医科大学附属无锡人民医院神经外科（邵君飞）
通讯作者：邵君飞，E-mail：wxbrain@163.com
Author(s):
HUANG Jin1;  WU Xiang-kui2;  ZHANG Yan-song3;  SHAO Jun-fei4.
1. Department of Neurosurgery, The First People’s Hospital of Zhengjiang City, Jiangsu 212000, China;
2. Department of Neurosurgery, People’s Hospital of Zhouzhi County, Shanxi 710400, China;
3. Department of Neurosurgery, Affiliated Nanjing Bra
关键词:
面肌痉挛; 微血管减压术; 肌电图监测; 疗效
Keywords:
Hemifacial spasm;  Microvascular decompression;  Electromyogram monitoring;  Vascular compression
分类号:
R 745.1+2; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.03.011
文献标志码:
A
摘要:
目的 探讨面肌肌电图监测在面肌痉挛微血管减压术（MVD）中的应用价值。方法 回顾性分析MVD治疗的72例面肌痉挛患者的临床资料，术中仔细辨别并处理责任血管，通过实时记录面肌的肌电反应了解减压效果。结果 60例有明确责任血管压迫，6例单纯性蛛网膜粘连或增厚，6例存在隐匿性责任血管。术后异常肌电图波形完全消失54例，基本消失16例，无明显变化2例。术后临床症状完全消失57例，部分消失14例，无改善1例；总有效率为98.6%（71/72）。结论 面肌肌电图监测可实时了解术中减压效果，对面肌痉挛的MVD，尤其是隐匿性责任血管所致面肌痉挛具有重要的指导作用。
Abstract:
Objective To explore the applied value of intraoperative electromyography (EMG) monitoring to microvascular decompression for hemifacial spasm. Methods The clinical data of 72 patients with hemifacial spasm, who underwent microvascular decompression under intraoperative EMG monitoring, were analyzed retrospectively. The real-time recording of EMG response of facial muscles was performed by the needle electrode put into the ipsilateral orbicularis oculi muscle, orbicularis oris muscle and masseter. Intraoperative careful identification and treatment of vessels responsible for hemifacial spasm in order to understand the effect of decompression and Objectively evaluate the prognoses of the patients. Results The blood vessels responsible for the hemifacial spasm were definitely determined in 60 patients. The arachnoid adhesion or thickening was found in 6 patients. The occult blood vessels probably were the vessels responsible for the hemifacial spasm in 6 patients. The abnormal EMG waveforms completely disappeared in 54 patients, almost disappeared in 16 and were unchanged in 2 after the decompression. The clinical symptoms disappeared completely in 57 patients, partly in 14 and were unchanged in 1 after the decompression. The overall effective rate was 98.6% (70/72). Conclusion The facial EMG monitoring is helpful to the intraoperative evaluation of the effect of decompression on the hemifacial spasm and the prognoses in the patients with hemifacial spasm. EMG monitoring plays an important guiding role in the microvascular decompression for hemifacial spasm, which especially caused by occult blood vessel.

参考文献/References:

[1] 吴国庆，吴国宏，王　蕾，等. 面肌痉挛微血管减压术中隐 匿性责任血管的辨别及处理[J]. 中华医学杂志，2010，90 （23）：1625-1627.
[2] Jannetta PJ. Hemifacial Spasm [M]. The Cranial Nerves. Berlin Heidelberg: Springer, 1981. 484-493.
[3] Bigder MG, Kaufmann AM. Microvascular decompression for hemifacial spasm: analysis of surgical failures and repeat surgery [J]. Neurosurgery, 2014, 61: 215-216.
[4] 邵　彤，刘学宽，种衍军，等. 提高颅神经显微血管减压术 疗效的临床研究（附1950例报告）[J]. 中华神经医学杂 志，2006，4（11）：1167-1168.
[5] Ying T, Thirumala P, Chang Y, et al. Emprical factors asso- ciated with brainstem auditory evoked potential monitoring during microvascular decompression for hemifacial spasm and its correlation to hearing loss [J]. Acta Neurochir(Wien), 2014, 156(3): 571-575.
[6] Kondo A, Date I, Endo S, et al. A proposal for standardized analysis of the results of microvascular decompression for trigeminal neuralgia and hemifacial spasm [J]. Acta neuro- chir (Wien), 2012, 154(5): 773-778.
[7] 卢　光，朱宏伟，张宇清，等. 面肌痉挛显微血管减压术后 远期疗效及影响因素分析[J]. 中国微侵袭神经外科杂 志，2014，19：160-163.
[8] 丰育功，姜元培，唐万忠，等. 面肌痉挛微血管减压手术技 巧及并发症分析（附34例报告）[J]. 中国临床神经外科杂 志，2011，16（11）：653-655.
[9] Habeych ME, Crammond DJ, Gardner P, et al. Intraoperative neurophysiological monitoring of microvascular decompre- ssion for glossopharyngeal neuralgia [J]. J Clin Neurophy- siol, 2014, 31(4): 337-343.
[10] 宋启民，程彦昊，戴　超，等. 旁路传导通路术中监测在原 发性面肌痉挛微血管减压术中的应用（附28例报道及文 献复习）[J]. 中华神经医学杂志，2014，13：169-172.
[11] Choi SI, Kim MW, Park DY, et al. Electrophysiologic inves- tigation during facial motor neuron suppression in patients with hemifacial spasm: possible pathophysiology of hemifa- cial spasm: a pilot study [J]. Ann Rehabil Med, 2013, 37(6): 839-847.
[12] Sun H, Li ST, Zhong J, et al. The strategy of microvascular decompression for hemifacial spasm: how to decide the endpoint of an MVD surgery [J]. Acta Neurochir (Wien), 2014, 156(6): 1155-1159.
[13] 刘永博，杨培中，王恩兴，等. 显微血管减压术治疗原发性 面肌痉挛292例临床分析[J]. 中华神经外科杂志，2012， 28：1168-1170.

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,(03):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,(03):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,(03):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,(03):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,(03):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]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]
[14]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]
[15]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,(03):526.[doi:10.13798/j.issn.1009-153X.2015.09.005]
[16]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]
[17]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,(03):262.[doi:10.13798/j.issn.1009-153X.2015.05.002]
[18]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,(03):549.[doi:10.13798/j.issn.1009-153X.2017.08.009]
[19]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,(03):308.[doi:10.13798/j.issn.1009-153X.2018.05.002]
[20]杨德宝、孟　璇、王安琪、周世军、陈寒春、蒋栋毅、王之敏.面肌痉挛微血管减压术后持续性异常肌反应对预后的影响[J].中国临床神经外科杂志,2019,(07):393.[doi:10.13798/j.issn.1009-153X.2019.07.004]
　YANG De-bao,MENG Xuan,WANG An-qi,et al.Effects of persistent abnormal muscle response after microvascular decompression on prognosis in patients with hemifacial spasm[J].,2019,(03):393.[doi:10.13798/j.issn.1009-153X.2019.07.004]

更新日期/Last Update: 2016-06-30