摘要
目的探讨微血管减压术治疗面肌痉挛出现并发症的影响因素。方法回顾性选取2017年1月~2019年1月在成都成飞医院接受微血管减压术治疗的120例面肌痉挛患者,统计患者临床治疗效果及术后并发症情况,分析术后并发症的相关危险因素。结果120例患者出院时治疗有效率为92.50%,出院半年后总疗有效率为95.83%。术后半年内38例患者出现脑脊液漏、听力障碍等并发症,并发症发生率为31.67%。多因素logistic回归分析表明,穿支血管包绕出髓区(OR:2.838,95%CI:1.534~5.250,P=0.001)、硬膜下操作时间(OR:3.823,95%CI:1.795~8.144,P=0.001)、骨窗前界到颞骨岩部内侧面的距离(OR:3.630,95%CI:1.590~8.288,P=0.002)是导致面肌痉挛患者术后并发症的独立危险因素。结论面肌痉挛患者行微血管减压术后并发症发生率较高,责任血管病变情况、硬膜下操作时间、骨窗前界到颞骨岩部内侧面的距离与微血管减压术后并发症的发生有关。
Objective To investigate the influencing factors of complications in microvascular decompression for treatment of hemifacial spasm.Methods 120 patients with hemifacial spasm who received microvascular decompression in the hospital from January 2017 to January 2019 were selected as subjects.The clinical treatment effect and postoperative complications were counted.The risk factors of postoperative complications were analyzed.Results The effective rate of 120 patients was 92.50%at discharge and 95.83%at six months after discharge.Complications such as cerebrospinal fluid leakage and hearing impairment occurred in 38 patients half a year after the operation,with a complication rate of 31.67%.Multivariate Logistic regression analysis showed that the occurrence of offending vessels that branched into the perforator vessels around the nerve pulp area(OR:2.838,95%CI:1.534~5.250,P=0.001),the long time of subdural operation(OR:3.823,95%CI:1.795~8.144,P=0.001),and the large distance from the window boundary to the inner flank of the temporal bone rock(OR:3.630,95%CI:1.590~8.288,P=0.002)were independent risk factors for postoperative complications in patients with hemifacial spasm.Conclusion The complication rate of microvascular decompression is higher in patients with hemifacial spasm.The incidence of complications after microvascular decompression is related to the pathological changes of the responsible vessels,the time of subdural operation and the distance from window boundary to inner flank of temporal bone rock.
作者
叶均
刘进
冯家丰
张雷
Ye Jun;Liu Jin;Feng Jiafeng(Department of Neurosurgery,Chengfei Hospital,ChengDu 610000,China)
出处
《中华保健医学杂志》
2020年第5期484-486,共3页
Chinese Journal of Health Care and Medicine
关键词
微血管减压术
面肌痉挛
安全性
危险因素
Microvascular decompression
Hemifacial spasm
Security
Risk factors
