[1]张熙,赵启梅,周乐,等.侧方扩散和面神经运动诱发电位监测在面神经微血管减压术中的意义[J].临床神经外科杂志,2015,(02):92-95.
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侧方扩散和面神经运动诱发电位监测在面神经微血管减压术中的意义()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
期数:
2015年02期
页码:
92-95
栏目:
显微血管减压术专题
出版日期:
2015-04-15

文章信息/Info

Title:
The clinical significance of lateral spread response and facial motor evoked potential during the microvascular decompression for hemifacial spasm patient
作者:
张熙 赵启梅 周乐 屈建强
西安交通大学第二附属医院神经外科
关键词:
面肌痉挛微血管减压术侧方扩散面神经运动诱发电位
Keywords:
hemifacial spasm microvascular decompression lateral spread response facial motor evoked potential
分类号:
R745.1
文献标志码:
A
摘要:
目的 探讨术中电生理监测对面肌痉挛微血管减压术的临床意义。方法 侧方扩散(lateral spread response,LSR)和面神经运动诱发电位(Facial motor evoked potential,FMEP)作为面肌痉挛的术中电生理监测。将2012年1月-2012年12月收治的72例面肌痉挛病人归为A组(无术中电生理监测),2013年1月-2014年1月收治的75例病人归为B组(应用术中电生理监测),比较两组间术后1周治愈率。将B组中病人分为LSR消失组和LSR未消失组,或者FMEP消失组和FMEP未消失组,比较各组术后1周治愈率。将LSR消失组分为眼轮匝肌LSR消失组,颏肌LSR消失组和眼轮匝肌和颏肌LSR同时消失组,比较各组术后1周治愈率。结果 A组治愈率为72.2%,B组治愈率为86.7%,两组差异具有统计学意义(P<0.05),LSR消失组的治愈率(92.3%)显著高于LSR未消失组(50.0%)。眼轮匝肌LSR组治愈率为88.9%,眼轮匝肌和颏肌LSR同时消失组治愈率为97.7%,两组差异无统计学意义(P>0.05),颏肌LSR消失组治愈率为75%,显著低于眼轮匝肌和颏肌LSR同时消失组。FMEP消失组和FMEP未消失组的治愈率分别为93.1%和64.7%,两组间差别具有统计学意义(P<0.05)。FMEP消失组中, LSR消失率为98.3%,FMEP未消失组中,8例患者LSR消失,LSR消失率为47.1%,两组差异具有统计学意义(P<0.01)结论 面神经微血管减压术中应用LSR和FMEP联合监测可以更好判断责任血管,提高面肌痉挛疗效。
Abstract:
Objective To investigate the clinical significance of intraoperative electrophysiological monitoring during the microvascular decompression(MVD) for hemifacial spasm patient. Methods Lateral spread response(LSR) and facial motor evoked potential(FMEP) were used for intraoperative electrophysiological monitoring.147 hemifacial spasm cases were treated with MVD,including 72 cases from January 2012 to December 2012 without intraoperative electrophysiological monitoring(group A) and 75 cases from January 2013 to January 2014 with intraoperative electrophysiological monitoring(group B).The one week postoperative cure rate was analyzed between the two groups. Then we divided group B to two groups: LSR disappear group and LSR no disappear group, or FMEP disappear group and FMEP no disappear group. At last,we divided LSR disappear group to three groups: single orbicularis muscle LSR disappear group; single mentalis LSR disappear group and orbicularis muscle and mentalis LSR disappear group. The one week postoperative cure rate between the groups was also analyzed. Result The cure rate in group A was 72.2%,it is significantly lower than that in group B(86.7%). The cure rate was 92.3% in LSR disappear group and 50.0% in LSR no disappear group. There are significant difference between the two groups. The cure rate in FMEP disappear group was 93.1%,which was significantly higher than that in FMEP no disappear group(64.7%) . The cure rate was 88.9% in single orbicularis muscle LSR disappear group and 97.7% in orbicularis muscle and mentalis LSR disappear group,there was no significant difference between the two groups.But the cure rate in single mentalis LSR disappear group was 75.0%,which was significantly lower than that in orbicularis muscle and mentalis LSR disappear group.The LSR disappear rate in FMEP disappear group was 98.3%,which was significantly higher than that in FMEP no disappear group(47.1%).Conclusion Combination of LSR and FMEP is useful to identify the offending vessel and can improve the effection of MVD.

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备注/Memo

备注/Memo:
[收稿日期] 2013-05-31 [基金项目]陕西省社发攻关项目
更新日期/Last Update: 2015-04-15