面神经传导检测和瞬目反射对小儿面神经炎早期诊断的价值

Value of Facial Nerve Conduction Detection and Blink Reflex in Early Diagnosis of Pediatric Facial Neuritis

目的研究面神经传导检测和瞬目反射对小儿面神经炎早期诊断的价值。方法对本院72例面神经炎患儿进行研究,按病程1~3 d,4~7 d,8~14 d分组,所有患儿均进行面神经传导检测及瞬目反射检查,治疗结束后1个月及3个月时复查。结果在发病后1~3 d,患儿面神经传导检测和瞬目反射的阳性率分别为71.43%、100.00%,瞬目反射的特异性较高;发病后4~7 d,患儿面神经传导检测和瞬目反射的阳性率分别88.00%、100.00%,瞬目反射的特异性仍较高;在发病8~14 d,患儿面神经传导检测和瞬目反射的阳性率分别为96.15%、90.48%;发病1周后,二者异常率相差不大,且二者特异性均较高。治疗后1个月复查,患儿面神经传导检测和瞬目反射的阳性率分别为63.89%、29.17%,瞬目反射异常率明显低于面神经传导检测。结论小儿面神经炎发病1周内,尤其是3 d内,瞬目反射特异性更显著。发病1周后,面神经传导检测和瞬目反射均有较高的特异性,经过治疗后1个月,患儿临床症状减轻,但未完全正常,而瞬目发射大多恢复正常,神经传导检测大多轻度异常,提示瞬目反射生理指标较面神经传导检测恢复快,而面神经传导检测恢复的滞后性更强。

Objective To study the value of detection of facial nerve conduction and blink reflex in early diagnosis of pediatric facial neuritis. Methods Seventy-two patients with facial neuritis were divided into groups of 1-3 days, 4-7 days and 8-14 days. All patients were examined by facial nerve conduction and blink reflex. Results At 1 to 3 days after onset, the positive rates of facial nerve conduction and blink reflex were 71.43% and 100.00%, respectively. The specificity of blink reflex was high. The positive rates of facial nerve conduction test and blink reflex were 88.00% and 100.00%, respectively, 4 to 7 days after onset. The specificity of blink reflex was still high. The positive rates of facial nerve conduction and blink reflex were 96.15% and 90.48%, respectively, from 8 to 14 days after onset. After 1 week of onset, there was little difference in the abnormal rate between the two, and both of them had high specificity. One month after treatment, the positive rates of facial nerve conduction test and blink reflex test were 63.89% and 29.17%, respectively, and the abnormal rate of blink reflex was significantly lower than that of facial nerve conduction test. Conclusion Within 1 week, especially within 3 d, the specificity of blink reflex is more significant. After 1 week of onset, both had higher specificity and were treated. After 1 month, the clinical symptoms of the children were alleviated, but not completely normal, while most of the blink emission returned to normal, and most of the nerve conduction detection was slightly abnormal, suggesting that the physiological index of blink reflex recovered faster than that of facial nerve conduction detection, while the lag of facial nerve conduction detection recovery was stronger and had better clinical compliance.