显微血管减压术治疗面肌痉挛后出现延迟治愈的相关因素分析

The relative factors for delayed resolution of hemifacial spasm after microvascular decompression

目的探讨显微血管减压术(MVD)治疗面肌痉挛(HFS)术后延迟治愈的相关因素。方法回顾性分析行MVD治疗的415例HFS病人的临床资料,统计分析延迟治愈的相关因素。结果术后出现延迟治愈106例(25.5%),症状持续7 d～8个月后完全消失。延迟治愈的发生与病人性别、年龄、术中血管压迫情况无关(均P>0.05);与病史长短、术前症状严重程度、动脉硬化及异常面肌反应(AMR)有关(均P<0.05)。术前病史长短对延迟治愈持续时间影响最大,且二者呈一定正相关性(r=0.77,P<0.01)。结论延迟治愈为MVD治疗HFS术后较为常见的现象,发生原因尚不明确,术后病人应持续随访1年以上再进行疗效评价。

Objective To investigate the relative factors for delayed resolution of hemifacial spasm（HFS） treated by microvascular decompression（MVD）.Methods The clinical data of 415 patients with HFS treated by MVD were analyzed retrospectively.The relative factors resulting in delayed resolution were analyzed statistically.Results Delayed resolution occurred in 106 patients（25.5%） and the duration of delayed resolution was from 7 days to 8 months.There was no correlation between the occurrence of delayed resolution and the sex,age,intraoperative vessel compression of patients（all P 0.05）.There was correlation between the occurrence of delayed resolution and the medical history,severity of HFS,arteriosclerosis before operation and abnormal muscle response（AMR） during MVD（all P 0.05）.The most important factor for delayed resolution was medical history before operation and there was positive correlation between the duration of delayed resolution and the medical history before operation（r = 0.77,P 0.01）.Conclusions Delayed resolution is common in patients with HFS treated by MVD and the reason remains unclear.The surgical outcome of MVD for HFS should be evaluated after the follow-up period for at least 1 year.