摘要
目的 探讨影响面肌痉挛（ HFS）患者微血管减压术（ MVD）后发生迟发性面瘫（ DFP）的相关因素.方法 收集2015年1月至2017年2月神经外科就诊的MVD术后发生DFP的HFS患者30例为DFP组,同时收集同期接受MVD手术且效果良好无任何并发症的患者62 例为对照组.回顾性分析两组的一般资料和病症特征,采用多因素Logistic回归分析筛选出迟发性面瘫发病的相关因素.结果 多因素Logistic回归分析结果显示责任血管数量[OR（95%CI）＝3.129（1.021, 6.432）,P＜0.05]、责任血管对脑干区压痕[OR（95%CI）＝2.046（0.785, 4.252）,P＜0.05 ]是术后迟发性面瘫的危险因素,而围术期使用尼莫地平是 DFP 发生的独立保护因素[OR（95%CI）＝0.446（0.324, 0.975）,P＜0.05].结论 面肌痉挛患者的责任血管数量和责任血管对脑干区有压痕会增加MVD术后发生DFP的风险,而围术期使用尼莫地平则会降低DFP发生率.
Objective To investigate the related factors of delayed facial paralysis （DFP） after microvascular decompression （MVD） for patients with hemifacial spasm （HFS）.Methods Thirty cases of HFS appeared DFP after MVD were selected as DFP group from Jan 2015 to Feb 2017, at the same time, 62 patients after MVD with good efficacy and no complications were selected as the control group . The general data and disease characteristics of the two groups were retrospectively analyzed and com -pared.Multivariate Logistic regression analysis was used to screen the related factors of delayed facial pa-ralysis.Results Multiariable Logistic regression analysis results showed that the responsibility for vascu-lar number [OR （95%CI）=3.129 （1.021, 6.432）, P〈0.05）], the pressure marks of the responsi-ble blood vessels on the brainstem [OR （95%CI）=2.046 （0.785, 4.252）, P〈0.05] were the risk factors for delayed postoperative facial paralysis , the use of nimodipine during perioperative period was an independent protective factor for DFP [ OR （ 95%CI ）=0.446 （ 0.324, 0.975 ） , P〈0.05 ]. Conclusions The number of responsible blood vessels and the responsible blood vessels with indentation in the brain stem area will increase the risk of DFP after MVD in the patients with hemifacial spasm , the use of nimodipine during the perioperative period will reduce the incidence of DFP.
作者
凌兴飞
Ling Xindei(Department of Neurosurgery,Xinyang Central Hospital,Xinyang 464000,China)
出处
《中国实用医刊》
2018年第14期47-49,共3页
Chinese Journal of Practical Medicine
