摘要：

目的：探讨肉毒素注射治疗联合微血管减压术(microvascular decompression，MVD)对面肌痉挛患者的治疗效果。方法：选取2019年1月—2021年1月期间本院收治的104例面肌痉挛患者，以随机抽签分组法将患者分为联合治疗组和MVD组，每组各52例。MVD组给予MVD手术治疗，联合治疗组行MVD联合肉毒素注射液治疗。比较2组患者的临床疗效、电生理指标水平、血清学指标水平、生活质量评分、不良反应发生率。结果：联合治疗组总有效率为92.31%(48/52)，MVD组患者总有效率76.92%(40/52)，联合治疗组高于MVD组(P<0.05)。治疗后，联合治疗组患者的电生理指标——眼轮匝肌、口轮匝肌、乳突眼轮匝肌、乳突口轮匝肌的肌电位振幅均低于MVD组(P<0.001)。治疗后，联合治疗组血清学指标——乙酰胆碱酯酶(acetylcholinesterase，AchE)、突触相关膜蛋白(synapse associated membraneprotein，SAMP)、钙调蛋白(calmodulin，CaM)水平均低于MVD组(P<0.001)。治疗后，联合治疗组患者生活质量各项评分均高于MVD组(P<0.001)。治疗期间，联合治疗组、MVD组不良反应发生率分别为15.38%(8/52)、9.62%(5/52) (P>0.05)。结论：肉毒素注射治疗联合MVD法对面肌痉挛患者的临床疗效显著，能够诱发患者肌电图诱发运动电位的振幅下降，改善患者的AchE、SAMP、CaM等血清学水平，提高患者的生活质量，且治疗安全性较好，推荐临床上应用。

关键词: 面肌痉挛, 肉毒素, 微血管减压术, 临床疗效, 电生理指标, 血清学指标

Abstract:

Objective: To study the therapeutic effect of botulinum toxin injection combined with microvascular decompression (MVD) technique on the patients with facial spasm. Methods: Between January 2019 and January 2021, a total of 104 patients were screened to enter the study, and randomly divided into combined treatment group (n=52) and MVD group (n=52), respectively. MVD group patients underwent MVD operation, whereas the combined treatment group patients were treated with botulin injection combined with MVD. The clinical efficacy, electrophysiological index levels, serological index levels, quality of life scores and adverse reactions rates of the two groups were evaluated and compared. Results: The total effective rate of the combined treatment group was 92.31% (48/52), and the total effective rate of the MVD group was 76.92% (40/52), with statistically differences (P<0.05). After treatment, the electrophysiological indexes—orbicularis oculi muscle, orbicularis oris muscle, papillary orbicularis oculi muscle and papillary orbicularis oris muscle in the combined treatment group had lower muscle potential amplitudes than those in the MVD group (P<0.001). After treatment, the serum levels of acetylcholinesterase (AchE), synapse associated membrane protein (SAMP) and calmodulin (CaM) in the combined treatment group were lower than those in the MVD group (P<0.001). After treatment, the scores of quality of life in the combined treatment group were higher than those of the MVD group (P<0.001). During the treatment period, the incidence of adverse reactions in the combined treatment group and MVD group was 15.38% (8/52) and 9.62% (5/52), respectively (P>0.05). Conclusion: The current clinical study has evident benefits on botulinum toxin injection combined with MVD operation in the management of facial spasm, which can induce the amplitude of electromyogram induced motor potential to decrease, improve the serum levels of AchE, SAMP and CaM, and improve the quality of life and safety of patients. So it is recommended for clinical application.

Key words: facial spasm, botulinum toxin, microvascular decompression, clinical effect, electrophysiological indexes, serological indicators

中图分类号: 

• R782