急、慢性周围性面瘫患者头面部远红外热像的变化

Changes in Cephalofacial Far Infrared Thermogram among Acute and Chronic Peripheral Facial Paralysis Patients

目的了解急、慢性周围性面瘫患者头面部远红外热像的变化,为临床诊治周围性面瘫提供无创性客观评价指标。方法周围性面瘫的患者14例;接受健康体检者19例,作为正常对照组。应用ATIR-M301B非制冷焦平面医用远红外热像仪（热敏度为0.05℃）,在环境温度为20-25℃的检查室中,采取头、面部远红外热图。采用本机提供的分析软件,分别比较同一受检者左、右两侧面颊、内眦、眶上及额等测温区远红外热像的温度差,并行统计学分析。结果（1）头面部远红外热像显示正常组面颊、内眦、眶上及额部4个测温区左、右两侧的温度无明显差异（P〉0.05）。（2）头面部远红外热像的变化显示急性周围性面瘫患者患侧面颊、内眦、眶上及额等测温区温度明显高于健侧（P〈0.05,P〈0.001）。（3）3例病程为25d至1年的慢性周围性面瘫患者头面部远红外热像的变化显示慢性周围性面瘫患者患侧面颊、内眦、眶上及额等测温区的温度显示低于健侧。不同患者各测温区的温度呈现不同的差异,如2例患者呈现患侧下颌区、口区温度明显低于对侧;1例患者呈现患侧内眦区、眶上区及额区的温度明显低于对侧。结论远红外热像可较好地反映周围性面瘫患者头面部供血状态的变化,急性期面瘫侧呈充血性改变,慢性期面瘫侧呈缺血性改变。表明远红外热像可为临床诊治周围性面瘫提供无创的客观评价指标。

Objective To supply atraumatic and objective evaluation index in the treatment of peripheral facial paralysis by monitoring the changes in cephalofacial far infrared thermogram among acute and chronic peripheral facial paralysis patients. Methods Far infrared thermography was applied in fourteen cases of peripheral facial paralysis by taking head temperature. There were 19 healthy persons （ 10 males ,9 females ,age 26-73yrs） in the group of healthy persons accepting medical examination . Non-refrigerated focal plane thermal imaging system （ATIR-M301B） was used, whose temperature sensitivity was 0. 05℃ and working temperature was 20℃-25℃. After the checking spots were exposed, cephalofacial far infrared thermography data were collected and analyzed by software provided by the system. Temperature differences of both sides of cheeks, inner canthius, supraorbitals and forehead were compared in the same patient. Results （ 1 ） Far infrared thermography revealed that there were no obvious temperature differences between both sides of the cheeks, inner canthus, supraorbitals and forehead in the group of healthy persons （ P 〉 0. 05 ）. The temperature difference in the forehead area varied from 0. 01℃ to 0. 2℃, the average temperature difference was （0. 093 ±0. 056） ℃. In the cheeks area it varied from 0. 01℃ to 0. 24℃ ,the average temperature difference was （0. 091 ±0. 046） ℃ ;in the inner canthius area it varied from 0. 02℃ to 0. 26℃, the average temperature difference was （0. 119 ±0. 070） ℃ ;and in the supraorbital area it varied from 0. 01℃ to 0. 23℃, the average temperature difference was （0. 121 ± 0. 056）℃. （2） Far infrared thermography manifested that the obvious temperature differences existed between both sides of the cheeks, inner canthius, supraorbitals and forehead areas, which were higher on affected sides than unaffected ones in acute peripheral facial paralysis group（ P 〈 0. 05, P 〈 0. 001 ）. The temperature difference in the forehead area varied from 0. 2℃ to 2. 8℃, the average temperature difference was （0. 499 ±0. 698） ℃ ; in the cheeks area it varied from 0. 2℃ to 1.8℃, the average temperature difference was （0. 693 ±0. 412） ℃ ;in the inner canthius area it varied from 0. 2℃ to 1.2℃ ,the average temperature difference was （0. 559 ±0. 383） ℃ ;in the supraorbital area it varied from 0. 2℃ to 1.7℃, the average temperature difference was（ 0. 609 ±0. 412） ℃. （3） In three cases of chronic peripheral facial paralysis group with a course of from 1 week to more than 1 year, their far infrared thermography disclosed that temperature was much lower on the affected sides. The temperature difference in the forehead area varied from 0. 2℃ to 0. 5℃ ; in the cheeks area it varied from 0.7℃ to 0. 9℃ ; in the inner canthus area it varied from 0. 3℃ to 0.6℃ ; in the supraorbital area it varied from 0. 7℃ to 1.0℃. Temperature differences varied according to different cases, with lower temperature of mandible area and oral region on affected sides in 2 cases and lower temperature of inner canthus, supraorbitals and forehead area on affected sides in 1 case. Conclusions Far infrared thermography can be applied to reflect blood-supply state and its change in peripheral facial paralysis, which provides a visualized index for diagnosis and curative effects evaluation of the disease.