尼莫地平预防面肌痉挛微血管减压术后周围性面瘫和听力障碍临床研究

Clinical Study on Nimodipine for Preventing Peripheral Facial Paralysis and Hearing Impairment in Patients with Hemifacial Spasm After Undergoing Microvascular Decompression

目的探讨术前应用尼莫地平对面肌痉挛患者微血管减压术后周围性面瘫和听力障碍的影响。方法选取2015年1月至2017年1月行微血管减压术治疗的面肌痉挛患者108例,根据治疗方式不同分为对照组(50例)和观察组(58例)。对照组患者予以微血管减压术常规及面肌痉挛等对症治疗,观察组患者在对照组基础上于术前给予尼莫地平治疗。结果两组临床总有效率比较(96.00%比98.28%),差异无统计学意义(χ~2=0.515,P=0.473);观察组患者术后周围性面瘫发生率为8.62%,显著低于对照组的24.00%(χ~2=4.789,P=0.029);观察组患者术后听力障碍发生率为1.72%,显著低于对照组的16.00%(χ~2=7.164,P=0.007);两组患者均未出现明显严重不良反应。结论术前采用尼莫地平治疗经微血管减压术治疗的面肌痉挛的临床疗效类似于常规手术,但可显著降低患者术后周围性面瘫和听力障碍的发生率,可改善患者预后程度,值得临床推广。

Objective To investigate the effect of preoperative application of nimodipine on peripheral facial paralysis and hearing impair- ment in patients with hemifacial spasm after undergoing microvascular decompression（MVD）. Methods Totally 108 patients with hemifacial spasm undergoing MVD in our hospital from January 2015 to January 2017 were selected and divided into the control group（50 cases）and the observation group（58 cases） according to the different treatment methods. The control group was given MVD and symptomatic treatment of hemifacial spasm, on this basis, the observation group was treated with nimodipine. Results There was no significant difference in total effective rate between the two groups（96. 00% -5. 98. 28%, ;X2 = 0. 515, P = 0. 473）. After operation, the incidence rate of peripheral facial paralysis in the observation group was 8. 62% , which was significantly lower than 2 4.00% in the control group （;X2 = 4 .7 8 9 , P = 0. 029）. The incidence rate of postoperative hearing impairment in the observation group was 1. 72% , which was significantly lower than 16.00% in the control group （X2 = 7. 164, P = 0. 0 0 7 ） . No serious adverse reactions were found in the two groups. Conclusion The clinical efficacy of preoperative treatment with nimodipine in patients with hemifacial spasm undergoing MVD is similar to that of con-ventional operation, but it can significantly reduce the incidence rates of postoperative peripheral facial paralysis and hearing impairment, improve the prognosis of patients, hich is worthy of clinical promotion.