摘要
目的观察局麻下经乙状窦后进路三叉神经根减压术和面神经根疏理术治疗三叉神经痛和面肌痉挛过程中,患者常见刺激反应及术后脑血管意外情况。方法对2011-05/2012-12月实施的115例三叉神经根减压术(三叉神经痛组)和72例面神经根疏理术(面肌痉挛组)患者的头痛、头昏、眩晕、恶心呕吐、出汗等及心电图变化的发生率进行统计分析,比较手术前和手术减压时收缩压、舒张压、心率的变化。对2003-08/2012-12月完成的2250例该类手术患者中7例出现术后脑血管意外情况的患者进行回顾。结果头痛、头昏、眩晕、恶心呕吐、心慌、出汗的发生率,三叉神经痛组分别为81.7%、4.3%、4.3%、67.8%、4.3%、14.8%,面肌痉挛组为56.9%、29.1%、27.7%、68.0%、12.5%、33.3%;心电图短暂变化,三叉神经痛组为26.9%,面肌痉挛组为26.3%。三叉神经痛组和面肌痉挛组手术前和手术减压时,舒张压和收缩压差异有统计学意义,心率差异无统计学意义。术后出现严重脑血管意外的时间最短的发生在术后30 min,最长的发生在术后76h 45min,一般发生在术后24 h内。另外,7例术后脑血管意外患者的出血部位仅一例发生在手术区域。结论局麻下实施该类手术,患者较痛苦。脑血管意外一般在术后24 h内发生。手术并发的颅内出血不一定发生在手术区域。
Objective To observe the common stimulus response and postoperative cerebrovascular accidents of pa- tients undergoing antral backward road trigeminal root decompression and facial nerve root reorganizing surgery under lo- cal anesthesia to treat trigerninal neuralgia and hemifaeial spasm process. Methods The incidence of headache, dizziness, vertigo, nausea and vomiting, palpitation, sweating and electrocardiogram （ECG） changes of 115 cases undergoing tri- geminal nerve root decompression （trigeminal neuralgia group） and 72 cases undergoing facial nerve root the reorganizing surgery （hemifacial spasm group） between May 2011 and December 2012 were statistically analysed. The changes of sys tolic blood pressure, diastolic blood pressure and heart rate before and during surgery were compared. Seven patients with cerehrovascular accident among 225（I patients undergoing such surgery between August 20（/3 and December 2（712 were re- viewed. Results The incidence of headache, dizziness, vertigo, nausea and vomiting, palpitation in trigeminal neuralgia group was 81.7~, 4. 3~, 4. 3%, 67. 8%, 4. 3~, 14. 8%, in hemifacial spasm group was 56. 9~, 29. 1%, 27. 7%, 68.0%, 12.5%, 33.3% respectively. The incidence of short-term ECG changes in trigeminal neuralgia group was 26. 9%, and in hemifacial spasm group 26. 3~. Diastolic and systolic blood pressure were significantly different between two groups before and during surgery, and no difference was observed in heart rate. The earliest postoperative severe cer ebral vascular accident happened at 30 minutes after surgery and the latest happened at 76 hours and 45 minutes after sur- gery, and generally happened within 24 hours after surgery. Only one among these 7 patients had the bleeding site in the operation area. Conclusion The patient undergoing such surgery under local anesthesia is uncomfortable, even painful. Cerebrovascular accidents generally occur within 24 hours after surgery. Intracranial hemorrhage may not occur in the surgical area.
出处
《华南国防医学杂志》
CAS
2013年第11期796-798,共3页
Military Medical Journal of South China
关键词
局麻
神经根减压
刺激反应
脑血管意外
Local anesthesia
Nerve root decompression
Stimulus response
Cerebrovascular accident
