摘要
目的探讨外科手术治疗继发性面肌痉挛(HFS)患者的效果,评估原发性和继发性HFS在临床特征方面的可能差异。方法回顾性分析自2009年1月至2016年6月在上海交通大学医学院附属新华医院施行微血管减压术的3140例HFS患者的临床资料。其中,26例为继发性HFS(继发性HFS组),3114例为原发性HFS(原发性HFS组)。观察患者的临床特征,比较两组患者的临床资料、手术成功率及并发症发生率。结果继发性HFS患者术中发现责任血管19例(73.1%),其中,小脑前下动脉11例,小脑后下动脉2例,小脑前下动脉+小脑后下动脉4例,椎动脉+小脑前下动脉2例。继发性HFS组患者的平均年龄低于原发性HFS组,女性患者比例高于原发性HFS组,术中检测到异常肌肉反应波形患者比例低于原发性HFS组,差异均有统计学意义(P<0.05)。继发性HFS组术后1 d、7 d、1个月、3个月和1年的治疗有效率均低于原发性HFS组,术后7 d、1个月、3个月、1年的并发症发生率均高于原发性HFS组,差异均有统计学意义(P<0.05)。结论继发性HFS患者行肿瘤切除术后应探查面神经全程以检查可能存在的血管压迫。肿瘤切除术联合面神经微血管减压术是治疗继发性HFS患者的重要手段。
Objective To investigate the efficacy of surgical treatment of secondary hemifacial spasm(HFS)and to evaluate the possible differences in clinical characteristics between primary and secondary HFS.Methods The clinical data of 3140 HFS patients who underwent microvascular decompression from January 2009 to June 2016 were retrospectively analyzed.Among them,26 cases were secondary HFS(secondary HFS group)and 3114 cases were primary HFS(primary HFS group).The clinical characteristics of patients were observed,and the clinical data,surgical success rate and complication rate of the two groups were compared.Results There were 19 patients(73.1%)with secondary HFS were found to have responsible vessels during the operation,including 11 cases of anterior inferior cerebellar artery,2 cases of posterior inferior cerebellar artery,4 cases of anterior inferior cerebellar artery+posterior inferior cerebellar artery,and 2 cases of vertebral artery+anterior inferior cerebellar artery.The mean age of patients in the secondary HFS group was lower than that in the primary HFS group,the proportion of female patients was higher than that in the primary HFS group,and the proportion of patients with abnormal muscle response waveform detected during operation was lower than that in the primary HFS group,all the differences were statistically significant(P<0.05).The effective rate of treatment in the secondary HFS group at 1 day,7 days,1 month,3 months and 1 year after surgery was lower than that in the primary HFS group,and the complication rate at 7 days,1 month,3 months and 1 year after surgery was higher than that in the primary HFS group(P<0.05).Conclusion After tumor resection for secondary HFS patients,the facial nerve should be investigated for possible vascular compression.Tumor resection combined with facial microvascular decompression is an important method for the treatment of secondary HFS patients.
作者
周卫萍
王竹敏
夏云菲
张英
周萍
ZHOU Wei-ping;WANG Zhu-min;XIA Yun-fei;ZHANG Ying;ZHOU Ping(Department of Neurosurgery,Xin Hua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《临床军医杂志》
CAS
2020年第9期1027-1029,1033,共4页
Clinical Journal of Medical Officers
基金
上海市科委科研基金项目(16DZ2341800)
关键词
面肌痉挛
微血管减压术
异常肌肉反应
Hemifacial spasm
Microvascular decompression
Abnormal muscle response
作者简介
第一作者:周卫萍(1978-),女,上海人;通信作者:周萍,E-mail:splendid_ping@163.com
