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术中面神经直接刺激阈值对面神经减压术后恢复效果的预判价值

王璞 张文阳 王咏峰 夏寅

王璞, 张文阳, 王咏峰, 夏寅. 术中面神经直接刺激阈值对面神经减压术后恢复效果的预判价值[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2023-0161
引用本文: 王璞, 张文阳, 王咏峰, 夏寅. 术中面神经直接刺激阈值对面神经减压术后恢复效果的预判价值[J]. 协和医学杂志. doi: 10.12290/xhyxzz.2023-0161
WANG Pu, ZHANG Wenyang, WANG Yongfeng, XIA Yin. Predictive Value of Intraoperative Facial Nerve Response Thresholds on the Recovery Effect After Facial Nerve Decompression[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0161
Citation: WANG Pu, ZHANG Wenyang, WANG Yongfeng, XIA Yin. Predictive Value of Intraoperative Facial Nerve Response Thresholds on the Recovery Effect After Facial Nerve Decompression[J]. Medical Journal of Peking Union Medical College Hospital. doi: 10.12290/xhyxzz.2023-0161

术中面神经直接刺激阈值对面神经减压术后恢复效果的预判价值

doi: 10.12290/xhyxzz.2023-0161
基金项目: 

北京市自然科学基金青年项目(7234361)

详细信息
    通讯作者:

    王咏峰,E-mail:wangyongfeng96@163.com

    夏寅,E-mail:xiayin3@163.com

  • 中图分类号: R76;R651

Predictive Value of Intraoperative Facial Nerve Response Thresholds on the Recovery Effect After Facial Nerve Decompression

Funds: 

Beijing Natural Science Foundation-Youth Project (7234361)

  • 摘要: 目的 探究贝尔面瘫患者术中面神经直接刺激阈值与术后面神经功能恢复的关系。 方法 回顾性收集2015年10月—2022年10月于北京天坛医院行面神经减压手术的贝尔面瘫患者的临床资料,选取术中采用面神经监测并准确记录面神经直接刺激阈值以及术后至少有1年详细随访记录的患者进行统计分析,将术后面神经功能恢复至I~II级(HB分级)定义为术后恢复良好,恢复至III级及以上定义为恢复不良,并按面神经反应兴奋性将患者分为A、B两组,A组直接刺激阈值≤1.5mA,B组直接刺激阈值>1.5mA或刺激量增加至3mA仍未记录到神经反应波形,比较术后面神经功能恢复情况与面神经直接刺激阈值的关系。 结果 共36例符合纳入和排除标准的贝尔面瘫患者纳入本研究,均在发病1~3个月内接受经乳突-上鼓室入路面神经减压手术,术后面神经功能恢复良好组24例(66.7%),恢复不良组12例(33.3%),仅有20例(55.6%,20/36)患者术中记录到面神经直接刺激阈值,且均≤1.5 mA (0.1~1.5 mA),16例(44.4%,16/36)即使在面神经刺激量增加至3 mA也未能记录到面神经反应波形。术后面神经功能恢复良好组与恢复不良组在年龄、性别、面瘫侧别、手术时机、术前面神经电图等方面差异均无统计学意义(P均>0.05),但A组患者术后面神经功能恢复良好率明显高于B组(P=0.009)。 结论 对于行面神经减压手术的贝尔面瘫患者,术中面神经直接刺激阈值可能对术后面神经功能恢复具有一定预判价值。
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出版历程
  • 收稿日期:  2023-03-29
  • 网络出版日期:  2023-08-02

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