神经电生理监测下MVD术对面肌痉挛患者临床疗效及并发症的影响

Clinical Effect of MVD in Patients with Hemifacial Spasm Under Neuroelectrophysiological Monitoring and the Influence of Complications

目的:探究神经电生理监测下微血管减压(MVD)术对面肌痉挛(HFS)患者的临床治疗效果以及并发症的影响。方法:选取2016年5月—2021年6月郑州大学第五附属医院收治的78例HFS患者作为研究对象,按随机数表法分为对照组(39例)与监测组(39例)。两组患者均给予MVD术进行治疗,监测组患者在实施MVD术中进行神经电生理监测。观察监测组患者面神经侧方扩散反应(LSR)情况以及脑干听觉诱发电位(BAEP)中的V波情况,比较两组患者术后临床治疗效果以及术后并发症发生情况。结果:通过对监测组患者在MVD术中进行神经电生理监测发现,其中有5例患者LSR波形消失是在进行桥小脑角探测检查时,32例患者是在进行神经减压时消失,其余2例患者直至MVD手术结束LSR波形仍然可见。术后1 d,监测组患者治疗总有效率较对照组更高,差异有统计学意义(P<0.05);监测组患者并发症总发生率较对照组更低,差异有统计学意义(χ^(2)=22.675,P<0.05)。结论:HFS患者在神经电生理监测下实施MVD术进行治疗,临床治疗效果较为显著,同时,患者的并发症发生情况较少,比临床治疗HFS患者时单独采用MVD术进行治疗的方式更具优势,值得临床借鉴参考。

Objective:To explore the effect of MVD on the clinical treatment and complications of patients with hemifacial spasm under neuroelectrophysiological monitoring.Methods:78 patients with hemifacial spasm admitted to the hospital from May 2016 to June 2021 were selected as the study objects,and they were randomly divided into control group(39 cases)and monitoring group(39 cases).All patients in the 2 groups were treated with MVD,and neuroelectrophysiological monitoring was performed in the monitoring group during MVD.The lateral diffusion response(LSR)of facial nerve and the V-wave in brainstem auditory evoked potential(BAEP)of the monitoring group were observed,and the postoperative clinical treatment effect and postoperative complications of the two groups were compared.Results:Through neuroelectrophysiological monitoring during MVD operation in the monitoring group,it was found that LSR waveform disappeared during cerebellar pontine Angle detection in 5 patients,disappeared during nerve decompression in 32 patients,and LSR waveform remained visible in the remaining 2 patients until the end of MVD operation.The total effective rate of the monitoring group 1 day after surgery was higher than that of the control group(P<0.05).Total complication rate in the monitoring group was lower than that in the control group(χ^(2)=22.675,P<0.05).Conclusion:Patients with hemifacial spasm were treated with MVD under neuroelectrophysiological monitoring,and the clinical therapeutic effect is more significant.At the same time,the occurrence of complications in patients with hemifacial spasm is less,which was more advantageous than the clinical treatment of patients with hemifacial spasm by MVD alone,which is worthy of clinical reference.