异常肌反应在面肌痉挛显微血管减压术中的应用研究

Application of abnormal muscle response in microvascular decompression for hemifacial spasm

目的探讨异常肌反应(AMR)在面肌痉挛(HFS)微血管减压(MVD)术中的应用价值。方法对124例面肌痉挛MVD术治疗患者在术前及术后进行AMR监测;并分析术后AMR是否消失与手术效果的关系。结果MVD术后,本组患者中有92例患者的AMR消失,30例患者AMR持续存在。AMR消失组患者的术后即刻治愈率(87.0%)显著高于AMR未消失组(66.7%)(P=0.026);而两组患者的术后远期治愈率则无显著差异(P>0.05)。两组患者并发症的发生率亦无显著差异。结论面肌痉挛MVD术后AMR消失患者的即刻治愈率较高。但术后AMR持续存在并不代表治疗效果不良,AMR消失与否与面肌痉挛患者的远期效果没有明显关系;而AMR持续存在的患者可能面临着较高的延迟治愈发生率。

Objective To investigate the application value of abnormal muscle response(AMR)in microvascular decompression(MVD)for hemifacial spasm(HFS).Methods AMR was monitored before and after MVD in 124 patients with HFS,and the relationship between the disappearance of AMR and the effect of operation was analyzed.Results After MVD,AMR disappeared in 92 patients and persisted in 30 patients.The immediate cure rate(87.0%)of patients with AMR disappearance was significantly higher than that of patients without AMR disappearance(66.7%)(P=0.026),while there was no significant difference in the long-term cure rate between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups.Conclusions The immediate cure rate of patients with disappearance of AMR after MVD is higher.However,the persistence of AMR after operation does not mean that the treatment effect is poor.Whether AMR disappears or not has no significant relationship with the long-term effect of patients with hfs,and patients with persistent AMR may face a higher incidence of delayed cure.