神经电生理监测对面肌痉挛微血管减压术疗效的影响

Effect of intraoperative neural electrophysiological monitoring on the microvascular decompression surgery for hemifacial spasm

目的评价电生理监测结果对面肌痉挛微血管减压术疗效的影响。方法采用电生理监测术中面神经侧方扩散反应(LSR)的方法,对87例面肌痉挛的患者进行术中监测,根据监测结果对术中面神经减压效果进行评判,并将结果与81例未作监测的患者进行近期和远期疗效的对比。结果术后近期治愈率:监测组:87.4%,未监测组:74.1%,两组间比较有显著差异(P<0.05)。术后随访12个月治愈率:监测组:96.6%,未监测组:93.8%,两组间比较无显著差异(P>0.05)。结论根据监测结果对面神经减压术进行术中减压效果预判能够提高近期治愈率,降低术后延迟治愈的发生率。神经电生理监测对面肌痉挛微血管减压术的近期疗效具有明确影响。

Objective The effect of intraoperative monitoring of lateral spread response （LSR） on the microvascular decompression （MVD） surgery for hemifacial spasm. Methods A total of 87 hemifacial spasm patients who underwent LSR monitoring during MVD were analyzed. The resuhs were compared with another 81 hemifacial spasm patients without LSR monitoring during MVD. Results There was significant difference in achieved immediate remission between monitoring group （ 76, 87.4% ） and non-monitoring group （60, 74. 1% ）（ P 〈 0. 05 ）. There was no significant difference in recovery rate during 12-month follow-up between monitoring group （84, 96.6% ） and non-monitoring group （76, 93.8% ） （P 〉 0.05 ）. Conclusion The evaluation for the decompression effect by intraoperafive monitoring can increase the immediate remission rate and reduce the delayed recovery rate. Intraoperative neural electrophysiological monitoring can promote the immediate effect of the microvascular decompression surgery for hemifacial spasm patients.