上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (11): 1608-.doi: 10.3969/j.issn.1674-8115.2011.11.022

• 论著（临床研究） • 上一篇    下一篇

微血管减压术对特发性面肌痉挛的疗效分析

尚 明, 唐寅达, 郑学胜, 杨晓笙, 焦 伟, 李世亭   

  1. 上海交通大学 医学院附属新华医院神经外科, 上海 200092
  • 出版日期:2011-11-28 发布日期:2011-11-29
  • 通讯作者: 李世亭, 电子信箱: lsting66@163.com。
  • 作者简介:尚 明（1984—）, 男, 硕士生；电子信箱: Sming210@163.com。

Analysis of therapeutic effect of microvascular decompression surgery on idiopathic hemifacial spasm

SHANG Ming, TANG Yin-da, ZHENG Xue-sheng, YANG Xiao-sheng, JIAO Wei, LI Shi-ting   

  1. Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2011-11-28 Published:2011-11-29

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摘要：

目的 观察微血管减压术对不同责任血管压迫面神经不同区域的特发性面肌痉挛的治疗效果。方法 对采用微血管减压术治疗的特发性面肌痉挛病例的临床资料进行回顾性分析，548例患者根据责任血管压迫面神经区域的不同分成5组。A组（n=31）：血管压迫桥沿沟段；B组（n=59）：血管压迫脑干移行段；C组（n=47）:血管压迫出脑干段；D组（n=28）：血管压迫脑池段；E组（n=383）：多区域联合压迫。观察手术疗效，完全缓解和绝大部分缓解视为治疗有效。结果 术后随访0.5～2年。治疗有效率A组为96.8%，B组为96.6%，C组为97.8%，D组为96.4%，E组为94.5%。各组均无手术死亡病例，无完全性面瘫、颅内血肿形成、术后听力丧失等严重并发症发生病例。结论 微血管减压术是治疗面肌痉挛的首选方法，全程有序探查责任血管及充分减压是提高手术治愈率的关键。

关键词: 面肌痉挛, 微血管减压, 面神经

Abstract:

Objective To investigate the therapeutic effect of microvascular decompression surgery on idiopathic hemifacial spasm with compression on different zones of facial nerve. Methods The clinical data of 548 patients with idiopathic hemifacial spasm treated by microvascular decompression surgery were retrospectively analysed. Patients were divided into 5 groups according to compression on different zones of facial nerve by offending vessels. Root exit point was compressed in 31 patients (group A), transitional zone of brainstem was compressed in 59 patients (group B), attached segment of brainstem was compressed in 47 patients (group C), distal cisternal portion was compressed in 28 patients (group D), and two or more zones were compressed in 383 patients (group E). The therapeutic effect was observed, and complete remission and partial remission were regarded as effectiveness. Results Patients were followed up for 0.5 to 2 years. The effective rates were 96.8%, 96.6%, 97.8%, 96.4% and 94.5% in group A, group B, group C, group D and group E respectively. No death occurred in operation, and there were no severe complications such as complete facial paralysis, intracranial hematoma and hearing loss after operation. Conclusion Microvascular decompression surgery is the first choice for treatment of patients with hemifacial spasm. Proper detection of offending vessels and complete decompression may be the key factors to increase the cure rate.

Key words: hemifacial spasm, microvascular decompression, facial nerve