面神经加星状神经结阻滞治疗面神经炎的临床观察

A Clinic Observation on the Block of both Facial Nerve and Sellate Ganglion in the Treatment of Facial Neuritis

目的 :比较面神经阻滞加星状神经结阻滞与星状神经结阻滞治疗急性面神经炎的临床效果。方法 :6 6例急性面神经炎患者随机分成观察组和对照组 ,每组 33例。对照组采用星状神经结阻滞 (1次 /d) +10 %GS2 5 0ml内加入红花注射液 10ml+口服阿司匹林、地塞米松。观察组除采用对照组治疗外增加患侧面神经阻滞 (次 / 3d ,3次为1疗程 ,1个疗程后休息 1周 ,再行下一疗程 ,3个疗程为限 )。分别于疗程的第 7、15、30天对病人随访 ,记录患者嘴脸歪斜、口角下垂、鼓气试验、语言状态、溢泪等疗效情况进行比较。结果 :疗程第 7、15天各观察项目的优良率观察组与对照组相比有显著性差异 (P <0 .0 5 ) ;其中疗程第 7天嘴脸歪斜的优良率和口角下垂的优良率观察组与对照组相比有非常显著性差异 (P <0 .0 1) ,但总有效率两组相近无显著性差异P >0 .0 5 ;疗程第 7天的鼓气试验总有效率和优良率与对照组相比有显著性差异P <0 .0 5 ;疗程第 30天溢泪的总有效率观察组和对照组都达到 10 0 %。结论 :面神经阻滞加星状神经结阻滞早期用于治疗急性面神经炎能加速临床症状恢复 ,缩短疗程 ,但不能提高总有效率。

objective:To compare the clinic effect of facial nerve block(FNB)combine with sellate ganglion block(SGB) in the treatment of facial neuitis.Methods:Sixty-six cases with acute facial neuitis were divided into observation group(n=33) and control group(n=33)randomly.The SGB(q.d),10%GS250 ml+safflower injection 10ml(iv.drop q.d),aspirine and dexamethason for the control group.The observation group was treated with facial nerve block(BNK)[q3d]in addition of those done in the basis of control group.The SGB solution consisted of 0.5% bupivacaine 5 ml,vitamineB 1100 mg,vitamineB 12 1 mg and N、S to 10 ml.The FNB solution consisted of 0.5% bupvacaine 5 ml,vitamineB 6100 mg,25 mg and N、S to 10 ml.The patients were followed up at 7d,15 d and 30 d in period of treatment separately.The features deflection,spat sink,drum gas test, talk state and spill tear of patients were noted and assessed.Results:The choiceness ratio of all the items at 7d and 15d in period of stratement in observation group were significant difference from the control group(P<0.05).The choiceness ratio of features deflection and spat sink at 7d of observation group were very significant difference from the control group(P< 0.01).There was no significant difference of effective rate between the two groups(P> 0.05).The effective rate of spill tear at 30d in both groups was 100%.Conclusion:The FNB combined with SGB for the treatment of acute facial neuitis could accelerate the clinic symptom recover and shorten the period of treatment, but could not improve the overall effective rate.