| 罗飞
，姜海莉
，杨呈浩
，张明辉.三种不同显微血管减压技术
治疗面肌痉挛患者的疗效比较[J].神经损伤功能重建,2025,(7):383-388 |
| 三种不同显微血管减压技术
治疗面肌痉挛患者的疗效比较 |
| Comparison of Efficacy of Three Different Microvascular Decompression Techniques inTreating Patients with Hemifacial Spasm |
| |
| DOI： |
| 中文关键词: 面肌痉挛 显微血管减压术 面神经功能 治疗效果 听神经功能 复发 |
| 英文关键词: facial spasm microvascular decompression facial nerve function therapeutic effect auditory nerve function recrudescence |
| 基金项目:2019 年四川省医
学（青年创新）科
研课题（动脉瘤性
蛛网膜下腔出血患
者血管痉挛与局部
脑组织氧饱和度、
血浆内皮素-1的相
关性分析，No. S19
070） |
|
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| 中文摘要: |
| 目的：分析三种不同显微血管减压（microvascular decompression，MVD）技术治疗面肌痉挛（hemifacial spasm，HFS）患者的效果与安全性。方法：114例HFS患者，随机分为全程减压组、中枢减压组和监测减
压组各38例。3组均行MVD，全程减压组术中行面神经全程减压，中枢减压组术中行面神经中枢段减压，
监测减压组术中于神经电生理监测下行面神经中枢段减压。比较3组治疗效果、手术相关指标、手术前后
面部痉挛程度、面神经功能[House-Brackmann（H-B）分级、sunnybrook面神经评估系统（SFGS）]、听神经功能
[潜伏期、波间期、波幅脑干听觉诱发电位（BAEP）]、并发症发生率及复发率。结果：监测减压组、中枢减压
组总有效率高于全程减压组（P＜0.05）；监测减压组手术时间、术中出血量、住院时间＜中枢减压组＜全程
减压组（P＜0.05）；术后3个月、12个月监测减压组面部痉挛程度优于中枢减压组、全程减压组（P＜0.05）；监
测减压组术后3个月、12个月面神经功能H-B分级＜中枢减压组＜全程减压组，SFGS评分＞中枢减压组＞
全程减压组（P＜0.05）；监测减压组术后3个月、12个月BAEP潜伏期、波间期、波幅＞中枢减压组＞全程减
压组（P＜0.05）；监测减压组、中枢减压组并发症发生率低于全程减压组（P＜0.05）；3组复发率差异无统计
学意义（P＞0.05）。结论：MVD治疗HFS的过程中进行面神经中枢段减压，能优化手术流程，促进病情恢
复，增强临床效果，改善患者预后，尤其是在神经电生理监测下进行减压效果更加显著。 |
| 英文摘要: |
| To analyze the efficacy and safety of three different microvascular decompression
(MVD) techniques in treating patients with hemifacial spasm (HFS). Methods: A total of 114 HFS patients
were randomly divided into three groups, with 38 patients in each group: the full-course decompression group,
the central segment decompression group, and the monitored decompression group. All three groups underwent
MVD. In the full-course decompression group, full-course decompression of the facial nerve was performed
during surgery. In the central segment decompression group, only the central segment of the facial nerve was
decompressed. In the monitored decompression group, decompression of the central segment of the facial nerve
was carried out under intraoperative neurophysiological monitoring. The therapeutic effects, surgical-related
indicators, facial spasm severity before and after surgery, facial nerve function [evaluated using the
House-Brackmann (H-B) grading system and the Sunnybrook Facial Grading System (SFGS)], auditory nerve
function [assessed by latency, interpeak latency, and amplitude of brainstem auditory evoked potentials (BAEP)],
complication rates, and recurrence rates were compared among the three groups. Results: The total effective
rates in the monitored decompression group and the central segment decompression group were higher than that
in the full-course decompression group (P<0.05). The monitored decompression group had shorter operation
time, less intraoperative blood loss, and shorter hospital stay compared to the central segment decompression
group, which in turn had better outcomes than the full-course decompression group (P<0.05). At 3 months and 12
months postoperatively, the monitored decompression group showed superior improvement in facial spasm
severity compared to the central segment and full-course decompression groups (P<0.05). At 3 months and 12
months postoperatively, the H-B grades in the monitored decompression group were lower than those in the
central segment decompression group, which were lower than those in the full-course decompression group. The
SFGS scores in the monitored decompression group were higher than those in the central segment
decompression group, which were higher than those in the full-course decompression group (P<0.05). At 3
months and 12 months postoperatively, the BAEP latency, interpeak latency, and amplitude in the monitored
decompression group were better than those in the central segment decompression group, which were better than
those in the full-course decompression group (P<0.05). The complication rates in the monitored decompression group and the central
segment decompression group were lower than that in the full-course decompression group (P<0.05). There was no significant difference
in recurrence rates among the three groups (P>0.05). Conclusion: Performing central segment decompression of the facial nerve during
MVD for HFS can optimize the surgical process, facilitate disease recovery, enhance clinical efficacy, and improve patient prognosis. The
effect is particularly more pronounced when decompression is performed under neurophysiological monitoring. |
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