面肌痉挛微血管减压术中异常肌反应变化特点与术后疗效关系探究

目的探究面肌痉挛患者微血管减压术(MVD)中异常肌反应(AMR)的变化特点与术后疗效的关系,方法回顾性分析73例MVD术中采用AMR全程定量化监测患者的AMR变化特点,减压操作前AMR阈值较基础阈值升高≥1倍为A1组、<1倍为A2组,手术结束时AMR完全消失为B1组、未消失为B2组,B2组中AMR阈值较基础阈值升高≥1倍为B2a组、<1倍为B2b组,对各组的术后疗效进行对比分析。结果A1组21例中,19例立即治愈,1例延迟治愈,1例未愈;A2组52例中,35例立即治愈,9例延迟治愈,8例未愈。A1组较A2组疗效好(P=0.046)。BI组50例中,42例立即治愈,5例延迟治愈,3例未愈;B2组23例中,12例立即治愈,5例延迟治愈,6例未愈。B1组较B2组疗效好(P=0.003)。B2a组的治愈比例较B2b组高(分别为14/16.3/7),差异有统计学意义(P=0.045)。结论AMR在术中的变化特点对术者有重要参考意义,AMR在减压前升高、在手术结束时完全消失、未消失但升高较基础阈值≥1倍者术后疗效相对较好。

Relationship between the changing characteristics of abnormal muscle response in microvascular decompression for hemifacial spasm and treatment outcome after surgery

Objective To explore the relationship between abnormal muscle response (AMR) changing characteristics in microvascular decompression (MVD) for hemifacial spasm and treatment outcome after surgery.Methods A retrospective analysis was conducted on 73 patients whose AMR changing characteristics were quantitatively monitored during the whole process of MVD. Before decompression, the AMR threshold of group A1 increased one-fold or more compared with the basic threshold, while that of group A2 increased less than one-fold. After surgery, the AMR of group B1 completely disappeared, while that of group B2 did not disappear. For group B2, the AMR threshold of group B2a increased one-fold or more compared with the basic threshold, while that of group B2b increased less than one-fold. The treatment outcome of each group was comparatively analyzed.Results For 21 patients in group A1, 19 were cured immediately, 1 was cured later, and 1 was not cured; for 52 patients in group A2, 35 were cured immediately, 9 were cured later, and 8 were not cured. The treatment outcome of group A1 was significantly better than that of group A2 (P=0.046). For 50 patients in group B1, 42 were cured immediately, 5 were cured later, and 3 were not cured; for 23 patients in group B2, 12 were cured immediately, 5 were cured later, and 6 were not cured. The treatment outcome of group B1 was significantly better than that of group B2 (P=0.003). Group B2a had a significantly higher cure rate than group B2b (14/16 vs 3/7,P=0.045).Conclusions AMR changing characteristics have important reference significance for surgeons. The treatment outcome would be good in patients whose AMR increases before decompression, completely disappears after surgery, or does not disappear but increases one-fold or more compared with the basic threshold.