Bell麻痹患者的临床特征和临床预后分析

Clinical characters and prognosis for patients with Bell's palsy

目的总结Bell麻痹的疗效和治疗体会并探讨影响其预后的因素,为Bell麻痹的进一步防治提供科学依据。方法对2010年9月至2013年1月到我院治疗的222例Bell麻痹患者的人口学资料、临床特征及治疗情况进行回顾性统计分析。以House-Brackmann分级法作为面神经功能的评估标准。结果 Bell麻痹各年龄段均可发病,病变部分和性别分布差异均无统计学意义(P>0.05),其中160例(72.1%)3个月后完全恢复。入院时面肌完全瘫痪,发病到接受治疗超过3 d,缓慢起病,神经电图复合肌肉运动单位(CAMP)波幅比≤30%的患者完全恢复率降低,差异有统计学意义(P<0.05)。结论发病时面瘫的严重程度、发病后就诊时间、起病方式及波幅比是判断Bell麻痹预后的重要因素。

Objective To summarize the treatment experiences and clinical efficacy of Bell＇s palsy（idiopathic facial paralysis）, and to investigate the factors influencing the outcome of treatment. Methods A retrospective and epidemiological review of 222 patients with Bell＇s palsy admitted to our hospital from September 2010 to January 2013 were performed. Demographic data, clinical characteristics and management were processed for statistical analysis. Facial nerve function outcomes were evaluated with House-Brackmann grading system. Results There were no significant differences of involvement in either age group, sex and lesions location（P〉0.05）. Among the 222 patients, 160（72.1%） experienced complete recovery from Bell＇s palsy in 3 months. Patients with initial House-Brackmann grades VI, progressive onset, electroneurographically detected degeneration of no less than 70%, and duration between onset and treatment longer than three days were shown to have poor outcome of facial function（P〈0.05）.Conclusion The initial severity of paralysis, the ratio of wave amplitude, the onset styles, the time of starting treatment are found to be important factors in predicting the prognosis of Bell＇s palsy.