777例微血管减压术治疗面肌痉挛患者回顾性分析周 平 邓 燕 刘开军 李进榜 汤朝阳 王 辉
湖北医药学院附属太和医院，湖北 十堰 442000
通信作者：邓燕
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摘要】
目的 分析微血管减压术（MVD）治疗面肌痉挛的临床效果及并发症，总结不同责任血管处理经验。
方法 收集 2017-01—2020-12 湖北医药学院附属太和医院神经外科经微血管减压术治疗的面肌痉挛患者 777 例，根据责任血管分为 2 组，A 组 669 例责任血管为微小血管，B 组 108 例责任血管为椎动脉，回顾性分析相关临床资料。
结果 A 组中 577 例患者 MVD 术后面肌痉挛即刻恢复正常，88 例延迟恢复，4 例无效，4 例随访期间复发；术后 57 例面瘫，6 例听力损伤，1 例吞咽困难，1 例术后脑脊液漏。B 组中80 例患者术后立即恢复缓解，25 例患者延迟恢复，3 例患者无效，2 例患者随访期间复发；术后 13 例患者出现面瘫，4 例吞咽困难，4 例听力损伤。2 组术中均无死亡。
结论 椎动脉相关性面肌痉挛延迟治愈率及术后脑神经损伤发生率高于其他微血管相关性面肌痉挛，但远期脑神经损伤发生率无差异。
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关键词】 面肌痉挛；微血管减压术；椎动脉；脑神经损伤；复发
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中图分类号】 R745.1+ 2 【
文献标识码】 A 【
文章编号】 1673-5110 （2022） 08-0974-04
DOI：10.12083/SYSJ.220316 Retrospective analysis of 777 cases of hemifacial spasm treated by microvascular decompression
ZHOU Ping，DENG Yan，LIU Kaijun，LI Jinbang，TANG Chaoyang，WANG Hui
Taihe Hospital Affiliated to Hubei University of Medicine，Shiyan 442000，China
Corresponding author：DENG Yan
【Abstract】 Objective To analyze the clinical effect and complications of microvascular decompression in the treatment of facial spasm，and summarize the experience of different responsible vessels.Methods Totally 777 patients with hemifacial spasm treated by microvascular decompression in the Department of Neurosurgery of Taihe Hospital Affiliated to Hubei Medical College from January 2017 to December 2020 were collected. According to the responsible vessels，they were divided into two groups. Six hundred and sixty-nine patients in group A were responsible vessels，108 cases of vertebral artery were responsible vessels in group B. The relevant clinical data were analyzed retrospectively. Results In group A，577 patients recovered immediately after MVD，88 patients delayed recovery，4 cases were ineffective，and 4 cases recurred during follow-up. There were 57 cases of facial paralysis，6 cases of hearing impairment，1 case of dysphagia and 1 case of postoperative cerebrospinal fluid leakage. In group B，80 patients recovered immediately，25 patients recovered late，3 patients were ineffective，2 patients recurred during follow-up. There were 13 cases of facial paralysis，4 cases of dysphagia and 4 cases of hear⁃ing loss. Conclusion The delayed cure rate and postoperative cranial nerve injury rate of vertebral artery related facial spasm are higher than those of other microvascular related facial spasms. However，there was no significant difference in the incidence of long-term cranial nerve injury。
【Key words】 Hemifacial spasm；Microvascular decompression；Vertebral artery；Cranial nerve injury；Recurred
