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目的分析面神经远端血管压迫对面肌痉挛显微血管减压术临床疗效的影响。方法面肌痉挛患者115例,所有患者均行显微血管减压术,同时利用监测面神经侧方扩散反应(LSR)法展开术中监测;对34例单纯面神经根出脑干区减压后LSR未消失患者进行面神经远端探查,发现其中17例患者有面神经远端血管压迫现象,给予充分减压后分析治疗效果。结果 17例患者在手术结束后14例LSR完全消失,其他3例患者LSR并未消失;手术治疗效果为12例患者均于手术结束时抽动完全消失,其他5例患者出院时面部仍有抽动,经8~12个月随访面部抽动均完全消失。术后并发症为听力下降2例,颅内感染2例,经处理均得到有效改善。结论面神经远端血管压迫对面肌痉挛显微血管减压术治疗效果有显著影响,按照LSR监测结果为存在远端血管压迫的患者展开减压治疗,可降低手术并发症发生率,值得在临床中推广。
Objective To analyze the effect of distal facial nerve compression on the clinical curative effect of hemifacial spasm by microvascular decompression. Methods One hundred and fifteen patients with hemifacial spasm were included in this study. All patients underwent microvascular decompression. At the same time, intraoperative monitoring was performed by monitoring the lateral diffusion reaction (LSR) of the facial nerve. 34 patients with simple facial nerve root decompression The patients who did not disappear had facial nerve distal exploration, in which 17 cases were found to have distal facial compression of facial nerve. After sufficient decompression, the curative effect was analyzed. Results The LSR of 14 patients disappeared completely in the 17 patients and the LSR of the other 3 patients did not disappear at the end of the operation. The surgical treatment effect was that all the 12 patients disappeared completely at the end of the operation, and the other 5 patients still had twitch on the face, After 8 to 12 months of facial twitching were completely disappeared. Postoperative complications were 2 cases of hearing loss, 2 cases of intracranial infection, were effectively treated. Conclusion The distal facial nerve compression has a significant effect on the treatment of hemifacial spasm by microvascular decompression. According to the results of LSR, decompression therapy can reduce the incidence of complications in patients with distal vascular compression, which is worthy of clinical application Promotion.