尼莫地平对面肌痉挛患者微血管减压术后周围性面瘫及听力的影响

Effects of Nimodipine on Peripheral Facial Paralysis and Hearing in Mimetic Convulsion Patients after Microvascular Decompression

目的:观察尼莫地平对面肌痉挛患者微血管减压术后周围性面瘫及听力的影响。方法:选取行微血管减压术治疗的面肌痉挛患者162例,按随机数字表法分为对照组和观察组,各81例。对照组患者微血管减压术后给予常规针灸、营养神经治疗,观察组患者在对照组基础上术后以2 mg/h静脉泵入尼莫地平注射液40 mg,qd,治疗3 d,然后口服尼莫地平片40 mg,qd,治疗10 d。观察两组患者治疗后周围性面瘫、听力障碍的发生率及面瘫发病起始时间、持续时间、病变程度。结果:治疗后,观察组患者周围性面瘫和听力障碍的发生率分别为8.6%和6.2%,均显著低于对照组患者的14.8%和11.1%,差异有统计学意义(P<0.05);术后,观察组患者周围性面瘫发病起始时间为(15.32±3.15)d,晚于对照组的(12.21±2.16)d,持续时间为(36.52±5.84)d,显著低于对照组的(44.73±6.57)d,差异均有统计学意义(P<0.05)。术后,经House-Brackman分级法评价,观察组患者Ⅲ、Ⅳ级面瘫发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:尼莫地平能明显降低面肌痉挛患者微血管减压术后周围性面瘫和听力障碍的发生率,有助于损伤神经功能的恢复。

OBJECTIVE：To observe the effects of nimodipine on peripheral facial paralysis and hearing in mimetic convulsion patients after microvascular decompression. METHODS：162 mimetic convulsion patients underwent microvascular decompression were enrolled in this study,and then randomly divided into control group and observation group,81 cases in each group. Control group was given routine microvascular decompression,and observation group was additionally given intravenous pump of Nimodipine injection 40 mg,qd,2 mg/h for consecutive 3 days after operation,and then given Nimodipine tablet 40 mg,qd,for 10 days.The incidence of peripheral facial paralysis and hearing disorder,onset time,duration time and severity of facial paralysis were observed in 2 groups. RESULTS：The incidence of peripheral facial paralysis and hearing disorder were 8.6% and 6.2% in observation group,which were significantly lower than 14.8% and 11.1% of control group,with statistical significance（P0.05）. The onset and duration time of peripheral facial paralysis was（15.32±3.15）d and（36.52±5.84）d in observation group,which were significantly later and lower than（12.21±2.16）d and（44.73±6.57）d of control group,with statistical significance（P0.05）. According to House-Brackman classification method,the incidence of Ⅲ、Ⅳ facial paralysis was lower in control group than that in observation group,with statistical significance（P0.05）. CONCLUSIONS：Nimodipine can significantly decrease the incidence of peripheral facial paralysis and hearing disorder in mimetic convulsion patients after microvascular decompression,and contributes to the recovery of injured nerve function.