神经内镜下微创手术治疗面肌痉挛的疗效

Effect of minimally invasive surgery under neuroendoscope on hemifacial spasm

目的探讨神经内镜辅助下显微镜血管减压术在面肌痉挛患者中的应用效果。方法分析2020年1月—2022年1月西藏自治区人民政府驻成都办事处医院收治的80例面肌痉挛患者的临床资料,其中40例患者为显微镜血管减压术治疗(A组),另外40例患者为神经内镜辅助下显微镜血管减压术治疗(B组)。分析两组患者的手术情况、治疗前后的面肌痉挛强度、临床疗效、术后并发症情况等。结果B组硬膜下操作时间<30 min的占比均高于A组,差异有统计学意义(P<0.05)。治疗后两组面肌痉挛强度较治疗前均改善,但两组间比较,差异无统计学意义(P>0.05)。A组和B组的临床总有效率分别为95.00%和92.50%,差异无统计学意义(P>0.05)。A组和B组的术后并发症总发生率分别为2.50%和5.00%,差异无统计学意义(P>0.05)。结论神经内镜辅助下显微镜血管减压术治疗面肌痉挛患者能够缩短硬膜下操作时间,具有一定临床应用价值。

Objective To compare the effect of neuroendoscopically assisted and microscopic vascular decompression in patients with hemifacial spasm.Methods The clinical data of 80 patients with facial spasm admitted to our hospital from January 2020 to January 2022 were analyzed retrospectively.Among them,40 patients were treated with microscopic vascular decompression(group A),and the remaining 40 patients were treated with microscopic vascular decompression assisted by neuroendoscope(group B).The operation,intensity of facial spasm before and after treatment,clinical efficacy and postoperative complications were compared between the two groups.Results The proportion of subdural operation time<30 minutes in Group B was higher than that in Group A,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the intensity of hemifacial spasm in group A before treatment(P>0.05),and the intensity of hemifacial spasm in group A after treatment was improved compared with that in the two groups before treatment,but there was no statistically significant difference between the two groups(P>0.05).The total clinical effective rate of group A and B was 95.00%and 92.50%,respectively,and the difference was not significant(P>0.05).The total incidence of postoperative complications in group A and group B was 2.50%and 5.00%,respectively,with no significant difference(P>0.05).Conclusion Neuroendoscopic assisted microvascular decompression can shorten the dural operation time in patients with facial spasm,and has certain clinical application value.