神经内镜下微血管减压术治疗面肌痉挛的疗效及并发症分析

Analysis of the effectiveness and complications of neuroendoscopic microvascular decompression in the treatment of hemifacial spasm

目的讨论神经内镜下微血管减压术治疗面肌痉挛的疗效及并发症发生情况。方法选择2017年1月—2019年3月徐州医科大学附属医院收治的经面神经磁共振确诊的面肌痉挛患者60例,按照治疗方式分成2组,每组30例。对照组采用单纯显微镜下微血管减压术治疗,观察组在神经内镜辅助下微血管减压术治疗。比较2组临床疗效、生活质量、并发症发生情况。结果治疗后,观察组临床总有效率明显高于对照组(P<0.05);2组特异性量表HFS-8评分均较治疗前降低(P<0.05),其中观察组特异性量表HFS-8评分明显低于对照组(P<0.05);观察组并发症发生率均明显低于对照组(P<0.05)。结论神经内镜下微血管减压术治疗面肌痉挛的疗效更显著,能发现显微镜下无法观察到的面神经背侧的责任血管,减少责任血管的遗漏和误判,患者术后生活质量更高,并发症更少,复发率更低;与单纯显微镜下微血管减压相比,具有明显的临床优势。

Objective To discuss the effectiveness of neuroendoscopic microvascular decompression in the treatment of hemifacial spasm and related complications.Methods A total of 60 patients who were diagnosed with facial spasm in the Affiliated Hospital of Xuzhou Medical University from January 2017 to March 2019 were enrolled.They were randomly divided into two groups(n=30).The control group received microvascular decompression under a simple microscope,while the observation group was given microvascular decompression assisted by a neuroendoscope.Both groups were compared for clinical effectiveness,quality of life,and complication incidence.Results After treatment,the observation group presented a higher total rate of clinical effectiveness than the control group(P<0.05).Decreased scores of HFS-8 were found in both groups after treatment,compared with those before treatment(P<0.05),where HFS-8 score was significantly lower in the observation group than that in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusions Endoscopic microvascular decompression is more effective in the treatment of hemifacial spasm,which is able to detect the responsible vessels on the dorsal side of the facial nerve that cannot be observed under a microscope,with higher quality of life,fewer complications and a lower incidence of recurrence.Neuroendoscopic microvascular decompression has obviously clinical advantages over microscopic microvascular decompression alone.