中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
41期
2920-2922
,共3页
高俊%李宽正%郭毅%窦万臣%李永宁%王任直
高俊%李寬正%郭毅%竇萬臣%李永寧%王任直
고준%리관정%곽의%두만신%리영저%왕임직
面部单侧痉挛%监测,手术中%显微血管减压术
麵部單側痙攣%鑑測,手術中%顯微血管減壓術
면부단측경련%감측,수술중%현미혈관감압술
Hemifacial spasm%Monitoring,intraoperative%Microvascular decompression
目的 探讨显微血管减压手术中,辅以异常肌反应电生理监测治疗面肌痉挛的临床应用价值.方法 北京协和医院于2009至2010年对47例原发性面肌痉挛患者均采用显微血管减压手术,手术过程中间断电刺激患侧面神经颧支,记录同侧口轮匝肌肌电位的变化情况.手术后随诊5~22个月.结果 47例患者在手术开始时,均可在痉挛侧记录到异常肌反应信号.在手术过程中的不同阶段里,42例患者痉挛侧异常肌反应信号消失(其中4、9及29例患者的异常肌反应信号分别于剪开硬膜时、分离蛛网膜时、垫开责任血管时消失);全部42例患者术后未再发作面肌痉挛.5例患者异常肌反应波形在手术结束时仍未消失;随访中发现其中2例患者的面肌痉挛症状完全消失,3例患者痉挛程度较术前明显缓解.结论 显微血管减压手术中辅以异常肌反应电生理监测,可帮助判定责任血管,提高手术的疗效.
目的 探討顯微血管減壓手術中,輔以異常肌反應電生理鑑測治療麵肌痙攣的臨床應用價值.方法 北京協和醫院于2009至2010年對47例原髮性麵肌痙攣患者均採用顯微血管減壓手術,手術過程中間斷電刺激患側麵神經顴支,記錄同側口輪匝肌肌電位的變化情況.手術後隨診5~22箇月.結果 47例患者在手術開始時,均可在痙攣側記錄到異常肌反應信號.在手術過程中的不同階段裏,42例患者痙攣側異常肌反應信號消失(其中4、9及29例患者的異常肌反應信號分彆于剪開硬膜時、分離蛛網膜時、墊開責任血管時消失);全部42例患者術後未再髮作麵肌痙攣.5例患者異常肌反應波形在手術結束時仍未消失;隨訪中髮現其中2例患者的麵肌痙攣癥狀完全消失,3例患者痙攣程度較術前明顯緩解.結論 顯微血管減壓手術中輔以異常肌反應電生理鑑測,可幫助判定責任血管,提高手術的療效.
목적 탐토현미혈관감압수술중,보이이상기반응전생리감측치료면기경련적림상응용개치.방법 북경협화의원우2009지2010년대47례원발성면기경련환자균채용현미혈관감압수술,수술과정중간단전자격환측면신경권지,기록동측구륜잡기기전위적변화정황.수술후수진5~22개월.결과 47례환자재수술개시시,균가재경련측기록도이상기반응신호.재수술과정중적불동계단리,42례환자경련측이상기반응신호소실(기중4、9급29례환자적이상기반응신호분별우전개경막시、분리주망막시、점개책임혈관시소실);전부42례환자술후미재발작면기경련.5례환자이상기반응파형재수술결속시잉미소실;수방중발현기중2례환자적면기경련증상완전소실,3례환자경련정도교술전명현완해.결론 현미혈관감압수술중보이이상기반응전생리감측,가방조판정책임혈관,제고수술적료효.
Objective To explore the clinical efficacy of microvascular decompression plus intraoperative monitoring of abnormal muscle response in the treatment of hemifacial spasm.Methods Between 2009 and 2010,a total of 47 patients underwent microvascular decompression for hemifacial spasm.There were 15 males and 32 females with an age range 23 -70 years old.During operations,intermittent electrical pulses were applied to stimulate the zygomatic branch of facial nerve at the spasm side.And evoked potentials were monitored in orbicularis oris.All patients were followed up for 5 - 22 months.Results The abnormal muscle responses were recorded pre-operatively in all 47 patients at the spasm side.In 42 patients,the abnormal muscle responses disappeared at the different stages of operations (4 while opening dura,9 while dissecting arachnoid membrane and 29 while separating responsible vessels).All 42 patients were cured during the follow-up period.In the remaining 5 patients,the abnormal muscle response were still recorded even at the end of operations.Two of 5 patients were free from spasm during the follow-up period while the symptoms of other 3 patients became obviously relieved.Conclusion The combined approaches of microvascular decompression and intraoperative monitoring of abnormal muscle response may assist the identification of responsible vessels and improve the outcomes of hemifacial spasm.