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目的探讨显微血管减压术治疗面肌痉挛的手术疗效及并发症。方法选取濮阳市安阳地区医院2006年1月—2013年06月采用显微血管减压术治疗HFS病例92例,现在对患者的临床资料进行回顾性分析。结果全部病例经6个月至7年随访,抽搐完全消失77例,术后明显减轻7例,部分减轻6例,手术无效2例,无复发。并发症主要包括听力障碍5例,面瘫13例,耳鸣4例,声音嘶哑1例,脑脊液漏2例,无死亡和致残病例发生。结论显微血管减压术是面肌痉挛最有效的治疗方法,娴熟的显微外科技术及桥小脑角区局部解剖知识、术中面神经根部的显露、正确识别责任血管、减压棉片的大小及放置的位置等是确保手术疗效及减少并发症的重要因素。
Objective To investigate the curative effect and complications of hemifacial spasm treated by microvascular decompression. Methods The hospital of Anyang in Puyang City from January 2006 to June 2013 was treated with microvascular decompression in 92 cases of HFS, and now the clinical data of patients were retrospectively analyzed. Results All cases were followed up for 6 months to 7 years. 77 cases of convulsions disappeared completely, 7 cases were relieved after operation, 6 cases were partially relieved, 2 cases were ineffective and no recurrence occurred. Complications included 5 cases of hearing impairment, 13 cases of facial paralysis, 4 cases of tinnitus, 1 case of hoarseness, 2 cases of cerebrospinal fluid leakage and no death or disability. Conclusions Microvascular decompression is the most effective treatment for hemifacial spasm. Skillful microsurgical techniques and knowledge of local anatomy of the cerebellopontine angle area revealed the presence of facial nerve root during operation. Correct identification of the responsible vessels and the size of the decompression pad And placement is to ensure the efficacy of surgery and reduce complications, an important factor.