Bel面瘫164例观察

Areportof164casesofBel′spalsy

为探讨不同的治疗方法与Ｂｅｌ面瘫预后关系，报告Ｂｅｌ面瘫１６４例，按治疗方法不同及面神经电图（ＥＮｏＧ）检查结果分为三组。Ａ组，ＥＮｏＧ患侧损失９０％以下；Ｂ１组，损失９０％以上，未行手术减压治疗；Ｂ２组，损失９０％以上，行手术减压治疗。所有病例皆观察１～３年以上，按稍加改进的Ｐｏｒｔｍａｎｎ评分法判定其面肌功能最后得分。结果Ａ组７７例，除３例为良好外，其他皆为满意，平均得分１９．２２±１．１８；Ｂ１组４１例，平均得分１４．４±３．４９；Ｂ２组４６例平均得分１５．４±２．０８。经统计处理Ｂ１组与Ｂ２组差异无显著性（Ｐ＞０．０５），Ａ组结果明显优于Ｂ１组及Ｂ２组（Ｐ＜０．０１）。Ｂｅｌ面瘫的预后主要与病损程度有关，ＥＮｏＧ损失９０％以下时预后良好，损失９０％以上时，减压手术及激素治疗，从统计学角度看。

InordertoresearchtherelationshipbetweenvariousmethodsoftreatmentandtheirprognosisonBel′spalsy,164casesofBel′sPalsywerereviewed.AccordingtotheresultsofENoGtest,164casesweredividedintothreegroupsA,B1andB2.GroupA:thepareticsideENoGlosswaslessthan90%,groupB1:theENoGlosswasmorethan90%andwithoutsurgicaldecompres-sionoffacialnerve,groupB2:theENoGlosswasmorethan90%andwithsurgicaldecompression.Alofthepatientshadfolowupfor1-3yearsorevenlongerafteronset.ThegradesofrecoveryoffacialfunctionwereevaluatedbymodifiedclassificationsystemasoriginalyproposedbyPortmann.Thefacialfunctionof77casesofgroupAwererecoveredsatisfactorilyexcept3patients,theaveragepointswere19.22±1.18.TheaveragepointsofgroupB1(41cases)andB246caseswere14.4±3.49and15.4±2.08respectively.ComparingtheresultswithgroupB1,B2andA,therewasnostatisticalsignificantdiference(P>0.05)betweengroupB1andB2,buttheresultsofgroupAwerestatisticalysignificantbetterthangroupB1andB2(P<0.01).TheprognosisofBel′spalsymightmainlydependonthedegreeofdegenerationoffacialnerve.Asatisfactoryrecoverycanbeex-pectedwhenENoGtestlosswaslessthan90%.IfENoGlosswasmorethan90%,neithersurgicaldecompressionnorsteroidstherapycouldchangetheprognosisstatisticaly.