中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
24期
36-38
,共3页
面肌痉挛%显微外科%血管减压%锁孔
麵肌痙攣%顯微外科%血管減壓%鎖孔
면기경련%현미외과%혈관감압%쇄공
Hemifacial spasm%Microsurgery%Vascular decompression%Keyhole
目的 探讨乙状窦后锁孔入路显微血管减压术治疗面肌痉挛的手术方法、效果及并发症.方法 回顾性分析120例乙状窦后锁孔入路显微血管减压术患者的临床资料、手术资料和随访结果.术前常规行CT、MRI检查排除继发性病因.术中采用乙状窦后锁孔入路,缓慢释放脑脊液,牵开小脑,探查面神经出脑干区,确认异常压迫血管,将其推离此区,并用适当大小的Teflon棉团絮状放置在责任血管和脑干之间,使责任血管远离面神经根部.结果 全部病例术中均发现有明确的压迫血管,主要为小脑前下动脉和后下动脉,其中小脑前下动脉54例(45.3％),小脑后下动脉41例(34.8％).全部病例随访0.5 ～8年,无复发病例,总有效率为97.5％.结论 乙状窦后锁孔入路显微血管减压术是治疗面肌痉挛的有效治疗方法,应作为临床治疗面肌痉挛的首选.
目的 探討乙狀竇後鎖孔入路顯微血管減壓術治療麵肌痙攣的手術方法、效果及併髮癥.方法 迴顧性分析120例乙狀竇後鎖孔入路顯微血管減壓術患者的臨床資料、手術資料和隨訪結果.術前常規行CT、MRI檢查排除繼髮性病因.術中採用乙狀竇後鎖孔入路,緩慢釋放腦脊液,牽開小腦,探查麵神經齣腦榦區,確認異常壓迫血管,將其推離此區,併用適噹大小的Teflon棉糰絮狀放置在責任血管和腦榦之間,使責任血管遠離麵神經根部.結果 全部病例術中均髮現有明確的壓迫血管,主要為小腦前下動脈和後下動脈,其中小腦前下動脈54例(45.3％),小腦後下動脈41例(34.8％).全部病例隨訪0.5 ～8年,無複髮病例,總有效率為97.5％.結論 乙狀竇後鎖孔入路顯微血管減壓術是治療麵肌痙攣的有效治療方法,應作為臨床治療麵肌痙攣的首選.
목적 탐토을상두후쇄공입로현미혈관감압술치료면기경련적수술방법、효과급병발증.방법 회고성분석120례을상두후쇄공입로현미혈관감압술환자적림상자료、수술자료화수방결과.술전상규행CT、MRI검사배제계발성병인.술중채용을상두후쇄공입로,완만석방뇌척액,견개소뇌,탐사면신경출뇌간구,학인이상압박혈관,장기추리차구,병용괄당대소적Teflon면단서상방치재책임혈관화뇌간지간,사책임혈관원리면신경근부.결과 전부병례술중균발현유명학적압박혈관,주요위소뇌전하동맥화후하동맥,기중소뇌전하동맥54례(45.3％),소뇌후하동맥41례(34.8％).전부병례수방0.5 ～8년,무복발병례,총유효솔위97.5％.결론 을상두후쇄공입로현미혈관감압술시치료면기경련적유효치료방법,응작위림상치료면기경련적수선.
Objective To investigate the operation method,effect and complications of microsurgical vascular decompression by sigmoid sinus posterior keyhole approach in treatment of hemifacial spasm.Methods The clinical data,operation data and follow-up results of 120 patients with microsurgical vascular decompression by sigmoid sinus posterior keyhole approach were retrospectively analyzed.CT,MRI examination was performed preoperatively to exclude secondary etiology.Sigmoid sinus posterior keyhole was used intraoperatively,the cerebrospinal fluid was released slowly,the cerebellum pulled,the facial nerve REZ was explorated,the anomalous vascular compression was confirmed and pushed away from the area,and the proper size of Teflon batt was placed between the responsible vessels and brain stem,to make the responsible vessels away from the facial nerve root.Results Clear pressure vessels were found in all cases,mainly were the anterior inferior cerebellar artery and posterior inferior artery,including 54 cases (45.3％) of anterior inferior cerebellar artery,41 cases (34.8％)of posterior inferior cerebellar artery.All patients were followed up for 0.5 to 8 years,no recurrence cases,and the total effective rate was 97.5％.Conclusions Microsurgical vascular decompression by sigmoid sinus posterior keyhole approach is the effective method for treating hemifacial spasm,should be the preferred method for clinical treatment of HFS.
