中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2012年
9期
923-927
,共5页
面肌痉挛%三叉神经痛%显微血管减压术%经乙状窦后入路
麵肌痙攣%三扠神經痛%顯微血管減壓術%經乙狀竇後入路
면기경련%삼차신경통%현미혈관감압술%경을상두후입로
Hemifacial spasm%Trigeminal neuralgia%Microvascular decompression%Posterior sigmoid sinus approach
目的 探讨显微血管减压术治疗常见颅神经疾病的并发症和临床疗效. 方法 对胜利油田中心医院神经外科自2006年9月至2011年5月收治且符合纳入标准的166例面肌痉挛和45例原发性三叉神经痛患者均行微骨孔乙状窦后入路显微血管减压术治疗,术后对2种患者并发症的发生情况进行分析,明确并发症发生情况有无差异;对患者进行至少3月以上临床随访,明确术后3d和术后3月颅神经症状消失情况有无差异. 结果 面肌痉挛和原发性三叉神经痛患者术后发热发生分别为51例、14例,面瘫发生分别为7例、1例,听力障碍发生分别为4例、2例,切口脑脊液漏发生分别为5例、2例,颅内感染发生分别为3例、2例;2种疾病患者手术并发症发生率比较差异无统计学意义(P＞0.05).166例面肌痉挛患者术后3d颅神经症状消失109例,术后3月颅神经症状消失153例,比较差异有统计学意义(P＜0.05);治愈率为92.2％;44例患者在术后3 d～3月间颅神经症状消失,存在颅神经症状延迟治愈情况.原发性三叉神经痛患者术后3d颅神经症状消失40例,术后3月颅神经症状消失42例,比较差异无统计学意义(P＞0.05);治愈率为93.3％.结论 微骨孔乙状窦后入路显微血管减压术治疗面肌痉挛和三叉神经痛在手术操作并发症发生上无明显差异,且该手术方式疗效确切,面肌痉挛患者可在术后短期内逐渐获益.
目的 探討顯微血管減壓術治療常見顱神經疾病的併髮癥和臨床療效. 方法 對勝利油田中心醫院神經外科自2006年9月至2011年5月收治且符閤納入標準的166例麵肌痙攣和45例原髮性三扠神經痛患者均行微骨孔乙狀竇後入路顯微血管減壓術治療,術後對2種患者併髮癥的髮生情況進行分析,明確併髮癥髮生情況有無差異;對患者進行至少3月以上臨床隨訪,明確術後3d和術後3月顱神經癥狀消失情況有無差異. 結果 麵肌痙攣和原髮性三扠神經痛患者術後髮熱髮生分彆為51例、14例,麵癱髮生分彆為7例、1例,聽力障礙髮生分彆為4例、2例,切口腦脊液漏髮生分彆為5例、2例,顱內感染髮生分彆為3例、2例;2種疾病患者手術併髮癥髮生率比較差異無統計學意義(P＞0.05).166例麵肌痙攣患者術後3d顱神經癥狀消失109例,術後3月顱神經癥狀消失153例,比較差異有統計學意義(P＜0.05);治愈率為92.2％;44例患者在術後3 d～3月間顱神經癥狀消失,存在顱神經癥狀延遲治愈情況.原髮性三扠神經痛患者術後3d顱神經癥狀消失40例,術後3月顱神經癥狀消失42例,比較差異無統計學意義(P＞0.05);治愈率為93.3％.結論 微骨孔乙狀竇後入路顯微血管減壓術治療麵肌痙攣和三扠神經痛在手術操作併髮癥髮生上無明顯差異,且該手術方式療效確切,麵肌痙攣患者可在術後短期內逐漸穫益.
목적 탐토현미혈관감압술치료상견로신경질병적병발증화림상료효. 방법 대성리유전중심의원신경외과자2006년9월지2011년5월수치차부합납입표준적166례면기경련화45례원발성삼차신경통환자균행미골공을상두후입로현미혈관감압술치료,술후대2충환자병발증적발생정황진행분석,명학병발증발생정황유무차이;대환자진행지소3월이상림상수방,명학술후3d화술후3월로신경증상소실정황유무차이. 결과 면기경련화원발성삼차신경통환자술후발열발생분별위51례、14례,면탄발생분별위7례、1례,은력장애발생분별위4례、2례,절구뇌척액루발생분별위5례、2례,로내감염발생분별위3례、2례;2충질병환자수술병발증발생솔비교차이무통계학의의(P＞0.05).166례면기경련환자술후3d로신경증상소실109례,술후3월로신경증상소실153례,비교차이유통계학의의(P＜0.05);치유솔위92.2％;44례환자재술후3 d～3월간로신경증상소실,존재로신경증상연지치유정황.원발성삼차신경통환자술후3d로신경증상소실40례,술후3월로신경증상소실42례,비교차이무통계학의의(P＞0.05);치유솔위93.3％.결론 미골공을상두후입로현미혈관감압술치료면기경련화삼차신경통재수술조작병발증발생상무명현차이,차해수술방식료효학절,면기경련환자가재술후단기내축점획익.
Objective To explore the incidence of operation complications and clinical curative effect of microsurgical vascular decompression on treatment of patients with common cranial nerve diseases. Methods One hundred and sixty-six patients with hemifacial spasm and 45 patients with primary trigeminal neuralgia,admitted to our hospital from September 2006 to May 2011,were collected in our study; all the patients under,vent microvascular decompression via a posterior sigmoid sinus key hole approach.Complications were analyzed after surgery for trigeminal neuralgia and hemifacial spasm patients to find the difference on complications between these 2 diseases. And at least 3-month clinical follow-up after microvascular decompression surgery was carried out to note the differences on disappearance of cranial nerve symptoms between 3 d and 3 months after the surgery. Results Postoperative fever in the patients with hemifacial spasm and trigeminal neuralgia was seen in 51 and 14 patients,prosopoplegia in 7 and 1 patient,hearing impairment in 4 and 2 patients,incisional cerebrospinal fluid leakage in 5 and 2 patients, and intracranial infection in 3 and 2 patients, respectively. Symptom disappearance was noted in 109 patients with hemifacial spasm 3 d after the surgery and in 153 patients 3 months after surgery with a cure rate up to 92.2％; 44 patients with disappearance of symptoms during the 3rd d to the 3rd months of surgery had delayed healing. The symptom disappearance was observed in 40 patients with trigeminal neuralgia 3 d after the surgery and in 42 patients 3 months after the surgery,with a cure rate reaching 93.3％. Conclusion No significant difference in the incidence of operation complications is noted between patients with trigeminal neuralgia and hemifacial spasm treated by microvascular decompression via a posterior sigmoid sinus key hole approach; the surgery enjoys exact effectiveness; and postoperative patients with hemifacial spasm may gradually get recovery in a short term.
