CAJ | 학술논문

目的：超声弹性成像观察微血管减压术前后面肌弹性变化对面肌痉挛患者预后影响。方法使用超声弹性成像观察正常对照组(n=30)和2013年4月-2014年4月航空总医院行微血管解压术面肌痉挛患者(n=25)眼匝轮肌和咬肌弹性变化，以抽搐部位分为左侧面肌痉挛组10例，右侧面肌痉挛组15例。观察术前1 d和术后1周面肌弹性变化对患者预后影响。结果正常对照组眼匝轮肌和咬肌左右对比应变率比差异无统计学意义；左侧面肌痉挛组左右侧对比眼匝轮肌纵切应变比，术前下眼睑(P=0.003)、术后上眼睑(P=0.00)及术后下眼睑(P=0.021)差异均有统计学意义；右侧面肌痉挛组左右侧对比眼匝轮肌纵切上术前下眼睑(P=0.00)和上眼睑(P=0.02)、术后上眼睑(P=0.005)差异有统计学意义；显示术前面肌痉挛组与正常对照组在眼匝轮肌上眼睑及下眼睑纵切应变比差异有统计学意义，术后患侧与正常对照组差异也有统计学意义；面肌痉挛组眼匝轮肌术前术后自身未痉挛侧同侧对照、咬肌左右、术前术后未痉挛侧及与正常对照组比较差异均无统计学意义。术后疗效：完全缓解12%(3/25)，明显缓解60%(15/25)，部分缓解20%(5/25)，无效8%(2/25)。结论超声弹性成像技术可以实时定性评价眼匝轮肌和咬肌弹性变化，可作为其术后预后评价方法。
목적：초성탄성성상관찰미혈관감압술전후면기탄성변화대면기경련환자예후영향。방법사용초성탄성성상관찰정상대조조(n=30)화2013년4월-2014년4월항공총의원행미혈관해압술면기경련환자(n=25)안잡륜기화교기탄성변화，이추휵부위분위좌측면기경련조10례，우측면기경련조15례。관찰술전1 d화술후1주면기탄성변화대환자예후영향。결과정상대조조안잡륜기화교기좌우대비응변솔비차이무통계학의의；좌측면기경련조좌우측대비안잡륜기종절응변비，술전하안검(P=0.003)、술후상안검(P=0.00)급술후하안검(P=0.021)차이균유통계학의의；우측면기경련조좌우측대비안잡륜기종절상술전하안검(P=0.00)화상안검(P=0.02)、술후상안검(P=0.005)차이유통계학의의；현시술전면기경련조여정상대조조재안잡륜기상안검급하안검종절응변비차이유통계학의의，술후환측여정상대조조차이야유통계학의의；면기경련조안잡륜기술전술후자신미경련측동측대조、교기좌우、술전술후미경련측급여정상대조조비교차이균무통계학의의。술후료효：완전완해12%(3/25)，명현완해60%(15/25)，부분완해20%(5/25)，무효8%(2/25)。결론초성탄성성상기술가이실시정성평개안잡륜기화교기탄성변화，가작위기술후예후평개방법。
Objective To assess the prognostic effect of the change of facial muscle strain in hemifacial spasm (HFS) patients with elastosonography before and after microvascular decompression (MVD).MethodsThe changes of orbicularis oculi muscle and masseter muscle strain in healthy subjects of control group (n=30) and hemifacial spasm patients of HFS group (n=25, including 10 on the left, 15 on the right according to the site of spasm) who underwent microvascular decompression in Aviation General Hospital from April 2013 to April 2014 were observed by elastosonography on 1st day preoperatively and seven days postoperatively respectively.ResultsThere was no difference in strain ratio of orbicularis oculi muscle between the upper eyelids and the lower ones as well as masseter muscle on left and right in control group. The strain ratio of orbicularis oculi muscle in left and right side in HFS left group had statistical difference in lower eyelid before operation (P=0.003), in both upper and lower lid after operation (P=0.000,P=0.021); The strain ratio of orbicularis oculi muscle in left and right side in HFS right group also had statistical difference in both lower and upper eyelid before operation (P=0.000,P=0.020) and in the upper lid after operation (P=0.005). The strain ratio of HFS group and control group showed significant difference in upper lid and lower lid, not only before MVD but also after MVD. Compared with the control group, there was no difference in the strain ratio of orbicularis oculi muscle in the non-HFS side before and after operation, the left and right side of masseter muscle, and the non-HFS lateral preoperatively and postoperatively in HFS group. Postoperative curative effect: the ratio of complete relief was 12% (3/25), obvious relief was 60% (15/25), incomplete relief was 20% (5/25), and no relief was 8% (2/25).Conclusion It suggests that elastosonography can qualitatively detect the stress of muscle in real-time and measure the change of muscle stress as the ratio of strain which can be the prognostic evaluation method of HFS patients.