摘要
目的探讨神经电生理监测在微血管减压术（MVD）中的应用价值和临床意义。方法回顾性分析121例神经电生理监测辅助下行MVD术的病例资料,其中原发性三叉神经痛50例,面肌痉挛64例,舌咽神经痛7例;均行显微镜下经枕下-乙状窦后入路MVD术,术中行脑干听觉诱发电位（BAEP）、异常肌反应（AMR）和肌电图（EMG）监测。结果三叉神经痛治愈46例,明显缓解3例,部分缓解1例;面肌痉挛治愈57例,明显缓解5例,部分缓解1例,无效1例;舌咽神经痛疗效佳6例,疗效一般1例。术后并发症主要有：面瘫1例,面部麻木8例,听力下降6例,耳鸣7例,吞咽障碍1例,声音嘶哑1例,颅内感染3例;随访6~12个月,多数并发症缓解,无复发和死亡病例。结论神经电生理监测辅助下行MVD术可提高手术疗效,有效保护脑神经功能,减少发生并发症,改善病人预后。
Objective To investigate the application value and clinical significance of neurophysiological monitoring in microvascular decompression（MVD）. Methods The data of 121 patients treated with MVD under neurophysiological monitoring were analyzed retrospectively, including 50 with idiopathic trigeminal neuralgia, 64 with hemifacial spasm and 7 with glossopharyngeal neuralgia.MVD was performed via suboccipital retrosigmoid approach under the microscope, and the monitoring of brainstem auditory evoked potential（BAEP）, abnormal muscle response（AMR） monitoring and electromyography（EMG） were performed intraoperatively.Results Cure was achieved in 46 patients, significant remission in 3 and partial remission in 1 in idiopathic trigeminal neuralgia. While cure in 57, significant remission in 5 and partial remission in 1 in hemifacial spasm. And better therapeutic efficacy was achieved in 6and good in 1 in glossopharyngeal neuralgia. The main complications included facial paralysis in 1 patient, acial numbness in 8 patients,hearing loss in 6, tinnitus in 7, swallowing disorder in 1, voice hoarse in 1 and intracranial infection in 3 after the operation, and most complications had been ameliorated during the follow-up period of 6 to 12 months. And no patient recurred and died. Conclusion MVD under neurophysiological monitoring can improve therapeutic efficacy, protect brain function effectively, reduce the complications and improve the prognosis.
作者
向兴刚
李大志
张永辉
昝向阳
依马木
赵永
蔡宁
林琳
Xiang Xinggang Li Dazhi Zhang Yonghui Zan Xiangyang Yi Mamu Zhao Yong Cai Ning Lin Lin(Department of Neurosurgery, Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Urumqi, Xinjiang 830002, Chin)
出处
《中国微侵袭神经外科杂志》
CAS
2016年第9期400-403,共4页
Chinese Journal of Minimally Invasive Neurosurgery
基金
新疆医科大学附属中医医院院校级课题项目(编号:zyy201407)
关键词
三叉神经痛
面部单侧痉挛
舌咽神经疾病
神经电生理监测
微血管减压术
trigeminal neuralgia
hemifacial spasm
glossopharyndeal nerve diseases
neurophysiological monitoring
microvascular decompression
