不同类型责任血管MVD治疗面肌痉挛的疗效

Efficacy of MVD with Different Types of Offending Vessels in the Treatment of Hemifacial Spasm

目的探讨不同类型责任血管微血管减压手术(microvascular decompression,MVD)治疗面肌痉挛(hemifacial spasm,HFS)的临床疗效。方法对作者医院2012-05/2016-05月收治的86例HFS患者均行MVD,根据责任血管类型的不同,分小血管压迫55例(A组)和椎-基底动脉复合体压迫31例(B组),比较两组HFS症状、术后并发症及术后复发等情况。结果两组术后HFS症状均明显改善,组间比较差异无统计学意义(P>0.05);组内手术前后比较差异有统计学意义(P<0.05);两组手术疗效比较,差异无统计学意义(P>0.05);随访1年内两组下颌缘支-眼轮匝肌反应消失率和延迟治愈率比较,差异有统计学意义(P<0.05);B组术后并发症总发生率为22.58%,与A组的5.36%比较差异有统计学意义(P<0.05);A组术后1年HFS复发4例(7.28%),B组复发2例(6.46%),两组复发率比较差异无统计学意义(χ~2=0.09,P=0.77)。结论 MVD治疗HFS疗效确切,根据责任血管类型的不同行不同的MVD治疗可有效提高治愈率,减少术后并发症。

Objective To explore the clinical symptoms of microvascular decompression(MVD)with different types of offending vessels in the treatment of hemi-facial spasm(HFS).Methods Eight-six HFS patients admitted to the hospital from May 2012 to May 2016 were all treated with MVD,and divided into group A(small vascular compression,n=55)and group B(vertebrobasilar artery complex compression,n=31)according to different types of offending vessels.The HFS symptoms,postoperative complications,recurrence,and etc were compared between two groups.Results The postoperative HFS symptoms in the two groups were obviously improved,and there was no significantly difference in the improvement of HFS symptoms between the two groups(P>0.05).And there was significantly different in all two groups before and after operation(P<0.05).There was no significantly difference in operation efficacies between the two groups(P>0.05).There were significantly differences in the rate of disappearance and delayed cure of mandibular margin-orbicularis oculi muscle within 1 follow-up year between two groups(P<0.05).There was significantly difference in the total incidence rate of the complications between group B and group A(22.58%vs.5.36%,P<0.05).At 1 year after operation,there were 4 cases(7.28%)of HFS recurrence in group A and 2 cases(6.46%)in group B,and there was no significantly different in the recurrence rate between the two groups(χ~2=0.09,P=0.77).Conclusion MVD is effective in the treatment of HFS.Different MVD treatments depending on the different types of offending vessels can effectively improve the cure rate and reduce the postoperative complications.