微血管减压术治疗面肌痉挛的远期效果

Long-term result of microvascular decompression in the treatment of hemifacial spasm

目的 探讨微血管减压术治疗面肌痉挛 1年以上的远期疗效。 方法 对 1987年 7月至 1999年 6月间 32 9例患者的临床资料及随访结果进行回顾性分析。 结果 本组患者随访 1～3年 97例 ,痉挛完全缓解 92 7% ,明显缓解 3 1% ,部分缓解 2 1% ,无改变 2 1% ;3～ 5年 77例 ,完全缓解 92 2 % ,明显缓解 3 9% ,部分缓解 1 3% ,无改变占 2 6 % ;5～ 10年 12 1例 ,完全缓解 90 9% ,明显缓解 4 1% ,部分缓解 2 5 % ,无改变 2 5 % ;10年以上 34例 ,痉挛完全缓解 91 2 % ,明显缓解 5 9% ,无改变 2 9%。32 9例中主观满意度≥ 80 %者占 82 1% ,痉挛复发率 5 2 % ,并发症发生率 5 5 %。结论 采用微血管减压术治疗面肌痉挛 ,尽量减少对脑神经及血管损伤 ,不遗漏面神经根附近的责任血管 ,是提高远期疗效减少并发症的重要环节。

Objective To study the long te rm result (over 1 year) of microvascular decompression in the treatment of hemifacial spasm. Methods Three hundred and tw enty nine patients with hemifacial pasm were treated with microvascular decomp ression from July 1986 to June 1999. Results I n 97 patients followed up for 1 3 years, the cure rate of spasm was 92 7%, t he mprovement 3.1%, and no improvenent rate 2.1%. In 77 patients followed up fo r 3 5 years,the cure rate of spasm was 92 2% and 34 patients followed up f or over 10 years,the cure rate of spasm were 91.2%. The recurrence rate of spa sm w as 5 2%. The occurrence rate of postoperative complications was 5 5%. [W T5”HZ]Conclusion To improve the long efficacy of microvas cular decompression hemifacial spasm, it is necessary to avoid injury to the carnial nerves and blood vessel and leaving out responsible blood vessels near hemifacial nerue.