微血管减压术治疗面肌痉挛的预后因素分析

The prognostic factors of microvascular decompression for hemifacial spasm

目的探讨影响面肌痉挛微血管减压术的预后因素。方法回顾性分析2009年6月至2010年10月间我科收治的852例面肌痉挛患者的临床资料、术中所见、电生理监测及疗效情况。通过Logistic回归模型分析影响面肌痉挛患者手术的预后因素。结果分析结果表明，患者病程长短（P=0．034）、术中发现明确的责任血管（P=0．029）、面神经表面有血管压迹（P=0．000）以及术后异常肌反应（AMR）完全消失（P=0．013）是影响面肌痉挛术后完全缓解的独立预后因素。结论面神经微血管减压术中应全程探查面神经，寻找是否有神经压迹，对责任血管的准确判断及电生理监测是提高手术疗效的关键。

Objective To evaluate the prognostic factors of microvascular decompression （MVD） for hemifacial spasm （HFS）. Methods The clinical data, intraoperative findings, eleetrophysiological recordings and clinical outcome of 852 patients with typical HFS admitted fo our department from June 2009 to October 2010 were retrospectively analyzed. Logistic regression analysis was used for the analysis of prognostic factors. Results The results showed that the course of disease （P = 0. O34）, the offending vessels （P = 0. 029）, facial nerve indentation （P = 0. 000） and disappearance of abnormal muscle response （AMR） （P = 0. 013 ） were the prognostic factors which affect the complete relief of HFS after MVD. Conclusion The sufficient decompression of facial nerve, searching for facial nerve indentation, accurate determination of offending vessels and AMR monitoring are the key factors to improve surgical therapeutic efficacy of MVD for HFS.