针刺预处理对面肌痉挛显微血管减压术后迟发性面神经麻痹的影响

Effect of Acupuncture Preconditioning After Microvascular Decompression of Hemifacial Spasm on Delayed Facial Nerve Palsy

目的:观察面肌痉挛患者经显微血管减压术后行针刺预处理对迟发性面神经麻痹的发病率、发病持续时间、面部神经损伤情况的影响。方法:将行显微血管减压术的356例面肌痉挛患者,随机分成两组。对照组给予激素、血管扩张剂、神经营养药物综合治疗。针药防治组在对照组基础上给予针刺处理,持续4周。随访时间6～12个月。分析比较两组患者迟发性面神经麻痹发生率、面神经损伤功能分级。结果:对照组出现迟发性面神经麻痹22例,发病率12.36%,其中Ⅱ级5例,Ⅲ级10例,Ⅳ级7例,术后发病持续时间(61.82±12.99) d。针药防治组出现迟发性面神经麻痹9例,发病率5.06%,其中Ⅱ级6例,Ⅲ级2例,Ⅳ级1例,术后发病持续时间(45.67±11.98) d。两组患者发病率、面神经损伤功能分级、迟发性面神经麻痹持续时间比较,差异均具有统计学意义(P<0.05)。结论:针刺预处理可以减少面肌痉挛患者显微血管减压术后迟发性面神经麻痹的发病率,并可将病程缩短、有效减轻面部神经损伤情况。

Objective:To observe the effect of acupuncture preconditioning on the incidence,duration of onset,and facial nerve injury of patients with hemifacial spasm after microvascular decompression.Methods:A total of 356 patients with hemifacial spasm who underwent microvascular decompression were randomly divided into two groups.The control group was given a comprehensive treatment of hormones,vasodilators,and neurotrophic drugs.The acupuncture control group was given acupuncture treatment in addition to that of the control group for 4 weeks.The follow-up period was 6 to 12 months.The incidence of delayed facial paralysis and functional grading of facial nerve injury were analyzed and compared between the two groups.Results:Twenty-two patients with delayed facial paralysis occurred in the control group,with an incidence of 12.36%,including 5 cases of gradeⅡ,10 cases of gradeⅢ,and 7 cases of gradeⅣ.The duration of onset was(61.82±12.99)days.There were 9 cases of delayed facial paralysis in the acupuncture control group,the incidence rate was 5.06%,including 6 cases of gradeⅡ,2 cases of gradeⅢ,and 1 case of gradeⅣ.The duration of onset was 45.67±11.98 d.The differences of the incidence of facial nerve injury,facial nerve injury function grading,and duration of delayed facial paralysis of the both group were statistically significant(P<0.05).Conclusion:Acupuncture preconditioning can reduce the incidence of delayed facial paralysis after microvascular decompression in patients with hemifacial spasm and shorten the course of disease and effectively reduce facial nerve injury.