神经电生理监测及多模态影像融合技术在面肌痉挛微血管减压术中的应用研究

Application Study of Neuroelectrophysiological Monitoring and Multimodal Image Fusion Technology in Microvascular Decompression Surgery for Hemifacial Spasm

目的探究神经电生理监测及多模态影像融合技术在面肌痉挛微血管减压术中的应用价值。方法将中国人民解放军联勤保障部队第九八八医院2018年3月至2023年8月收治的62例行面肌痉挛微血管减压术患者作为研究对象,根据随机数字表法分为对照组(31例,仅接受面肌痉挛微血管减压术治疗)与实验组(31例,接受面肌痉挛微血管减压术的基础上给予神经电生理监测及多模态影像融合技术),对比两组干预效果。结果手术后1周,实验组治疗有效率(93.55%)高于对照组(74.20%),差异有统计学意义(P<0.05)。手术后1个月,实验组治疗有效率(100.00%)与对照组治疗有效率(93.55%)比较,差异无统计学意义(P>0.05),但治愈率(90.32%)显著高于对照组(51.61%),差异有统计学意义(P<0.05)。实验组听力下降率(3.23%)、面瘫发生率(0)低于对照组(19.35%,12.90%),差异具有统计学意义(P<0.05)。实验组患者采用联合技术后显示,责任血管与患者术中所见血管完全一致;微血管减压术中侧方扩散反应(LSR)波形均消失,均能够监测到脑干听觉诱发电位(BAEP))波,且经颅面神经运动诱发电位(Facial-MEP)监测下均无报警。结论在面肌痉挛微血管减压术患者中应用神经电生理监测及多模态影像融合技术可促进治愈率提升,并发症降低,故可在临床使用。

Objective To explore the application value of neuroelectrophysiological monitoring and multimodal image fusion technology in microvascular decompression surgery for hemifacial spasm.Methods Sixty-two patients who underwent microvascular decompression surgery for hemifacial spasm at the 988th Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army from March 2018 to August 2023 were selected as the study subjects.They were randomly divided into a control group(31 cases,only receiving microvascular decompression surgery)and an experimental group(31 cases,receiving neuroelectrophysiological monitoring and multimodal image fusion technology in addition to microvascular decompression surgery)according to a random number table method.The intervention effects of the two groups were compared.Results One week after surgery,the treatment efficacy in the experimental group(93.55%)was higher than that in the control group(74.20%),with statistically significant differences(P<0.05).One month after surgery,there was no statistically significant difference in treatment efficacy between the experimental group(100.00%)and the control group(93.55%)(P>0.05),but the cure rate(90.32%)in the experimental group was significantly higher than that in the control group(51.61%),with statistically significant differences(P<0.05).The rates of hearing loss(3.23%)and facial paralysis(0)in the experimental group were lower than those in the control group(19.35%,12.90%),with statistically significant differences(P<0.05).After adopting the combined technology,the responsible vessels in the experimental group were completely consistent with the vessels observed during surgery;the lateral spread response(LSR)waveform disappeared during microvascular decompression surgery,brainstem auditory evoked potentials(BAEP)were monitored,and there were no alarms under transcranial facial nerve motor evoked potential(Facial-MEP)monitoring.Conclusion The application of neuroelectrophysiological monitoring and multimodal image fusion technology in microvascular decompression surgery for hemifacial spasm can promote the improvement of cure rates and reduce complications,making it suitable for clinical use.