面肌诱发肌电图在评估显微血管减压术治疗面肌痉挛的应用研究

Application Study of Facial Evoked Electromyography in Evaluating Microvascular Decompression Treating Hemifacial Spasm

目的研究面肌诱发肌电图在评估显微血管减压术治疗面肌痉挛的应用价值。方法将2010年1月至2012年12月北京大学深圳医院神经外科收治的面肌痉挛患者60例纳入研究,根据显微血管减压术后的面肌诱发肌电图检查结果分为下颌缘支-眼轮匝肌(MD-OC)反应阳性的30例患者作为阳性组和MD-OC反应阴性的30例患者作为阴性组,均应用显微血管减压术治疗,随访治疗效果及生活质量。结果术后1周时和术后6个月随访过程中,两组患者治疗疗效比较差异有统计学意义(Z=12.533,15.353,P<0.05)。阳性组患者术后的躯体、心理、社会、认知功能及生活总质量评分均明显低于阴性组[(68.4±9.1)分vs(75.1±11.3)分、(59.8±7.3)分vs(65.3±9.3)分、(63.3±9.4)分vs(71.8±11.3)分、(56.3±8.9)分vs(62.8±7.7)分,P<0.05]。结论面肌诱发肌电图能够较好地评价显微血管减压术后的治疗效果和生活质量,对于患者病情的评估具有积极临床价值。

Objective To study the application value of facial evoked electromyography in evaluating microvascular decompression treating hemifacial spasm.Methods A total of 60 patients with facial spasm admitted to Peking University Shenzhen Hospital Neurosurgery between Jan.2010 and Dec.2012 were included in the study,according to microscopic vascular decompression postoperative facial evoked electromyography results they were divided into mandibular margin-the orbicularis oculi muscle （MD-OC） positive group of 30 cases and MD-OC negative group 30 cases,and micro vascular decompression treatment was given to both groups,and the therapeutic effect and quality of life were followed up.Results 1 week after operation and during the 6 months follow-up,the difference in therapeutic effect between the two groups was statistically significant（Z =12.533,15.353,P =0.009）.Body,psychological,social,cognitive function and life quality score of the positive group were significantly lower than the negative group [（68.4 ± 9.1） vs （75.1 ± 11.3）,（59.8 ± 7.3） vs （65.3 ± 9.3）,（63.3 ± 9.4） vs （71.8 ±11.3）,（56.3 ±8.9） vs （62.8 ±7.7）,P ＜0.05].Conclusion Facial evoked electromyography has positive clinical value in the assessment of hemifacial spasm patient＇s condition,for it can well assess the therapeutic effect and quality of life after microvascular decompression.