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障碍的影响

Effect of Nimodipine on Peripheral Facial Palsy and Hearing Impairment after Microvascular Decompression in Patients with Anterior Myasthenia Gravis

目的:观察尼莫地平对面肌痉挛患者微血管减压术(MVD)后迟发性面瘫及听力障碍的影响。方法:选取2018年3月—2020年5月平顶山市第一人民医院神经外科收治的200例行微血管减压的单侧面肌痉挛患者作为研究对象,随机分为观察组和对照组,每组各100例。对照组患者给予围手术期MVD的常规治疗,观察组患者在围手术期MVD常规治疗的基础上,增加尼莫地平药物治疗。对比两组患者手术后治疗效果,迟发性面瘫及听力障碍的发生情况。结果:观察组面瘫发生率明显低于对照组,差异有统计学意义(χ^(2)=4.137,P<0.05);观察组患者面瘫平均发生时间高于对照组,差异有统计学意义(t=2.498,P<0.05);观察组患者面瘫平均恢复时间低于对照组,差异有统计学意义(t=5.758,P<0.05);观察组听力障碍发生率明显低于对照组,差异有统计学意义(χ^(2)=4.711,P<0.05)。结论:面肌痉挛患者围手术期使用尼莫地平不能影响MVD的有效率,可以降低术后迟发性周围性面瘫及听力障碍的发生率,并缩短面瘫恢复时间。

Objective:To observe the effect of nimodipine on delayed facial palsy and hearing impairment after microvascular decompression(MVD)in patients with anterior myasthenia gravis.Methods:200 patients with unilateral lateral myasthenia gravis admitted to the hospital from March 2018 to May 2020 with microvascular decompression were selected for the study and randomly divided into observation group and control group,with 100 cases in each group.The control group was given conventional treatment of perioperative MVD,and the observation group was given additional nimodipine medication on top of the conventional treatment of perioperative MVD.The treatment results,the occurrence of delayed facial palsy and hearing impairment were compared between the two groups after surgery.Results:The incidence of facial palsy in the observation group was significantly lower than that in the control group,and the difference was statistically significant(χ^(2)=4.137,P<0.05).The mean time to onset of facial palsy was higher in the observation group than in the control group,and the difference was statistically significant(t=2.498,P<0.05).The mean recovery time of facial palsy in the observation group was lower than that in the control group,and the difference was statistically significant(t=5.758,P<0.05).The incidence of hearing impairment in the observation group was significantly lower than that in the control group,and the difference was statistically significant(χ^(2)=4.711,P<0.05).Conclusion:Perioperative use of nimodipine in patients with facial spasm does not affect the efficiency of MVD,reduces the incidence of postoperative delayed peripheral facial palsy and hearing impairment,and shortens the recovery time of facial palsy.