摘要：

目的： 本文旨在探讨神经内镜联合显微镜微血管减压术对面肌痉挛患者面神经功能的影响。方法： 以自2016年12月—2019年10月我院收治的64例面肌痉挛患者为研究对象，按随机数字表法将患者分为研究组（32例，给予神经内镜联合显微镜微血管减压术治疗）和对照组（32例，给予单纯显微镜微血管减压术治疗）。统计治疗前、治疗3个月后及治疗12个月后2组患者面肌痉挛程度及面神经功能，记录治疗12个月后2组的临床疗效、复发情况及并发症发生情况。结果： 本研究中，2组患者均手术成功，治疗12个月后，研究组缓解率明显高于对照组，分别为100.00% 和 81.25%，组间比较差异具有统计学意义（P<0.05）。治疗前，2组患者面肌痉挛程度比较，差异无统计学意义（P>0.05）；治疗3个月后及治疗12个月后，研究组的面肌痉挛程度中0级、Ⅰ级明显多于对照组，组间比较差异具有统计学意义（P<0.05）。治疗前，2组面神经功能分级比较，差异无统计学意义（P>0.05）；治疗3个月后及治疗12个月后，研究组的面神经功能分级中0级、Ⅰ级及Ⅱ级均明显优于对照组，组间比较差异具有统计学意义（P<0.05）。在术后12个月的随访过程中，2组患者均无复发，且无相关并发症发生。结论： 神经内镜联合显微镜微血管减压术可有效治疗面肌痉挛患者，可改善其面神经功能，值得临床推广使用。

关键词: 神经内镜, 显微镜, 微血管减压术, 面肌痉挛, 面神经功能

Abstract:

Objective: This article aimed to investigate the effect of neuroendoscopy combined with microscopic microvascular decompression on facial nerve function in patients with hemifacial spasm. Methods: A total of 64 patients suffered from hemifacial spasm admitted to our hospital from December 2016 to October 2019 were selected as the research objects. According to a random number table method, they were divided into study group (32 cases were treated with neuroendoscopy combined microscopic microvascular decompression operation) and control group (32 cases were treated only with microscopic microvascular decompression surgery). The degree of spasticity and facial nerve function within and between the two groups before treatment, after 3 months of treatment and after 12 months of treatment were counted respectively. The clinical efficacy, recurrence rate and incidence of complications of the two groups after 12 months of treatment were recorded. Results: In this study, both groups of patients were successfully operated. After 12 months of treatment, the remission rate of the study group was significantly higher than that of the control group(100.00% vs 81.25%), and the comparison between groups was statistically significant(P<0.05). Before treatment, there was no significant difference in the degree of facial spasm between the two groups(P>0.05); after 3 months of treatment and 12 months of treatment, the degree of facial spasm in the study group was significantly better than that of the control group in terms of grade 0 and grade I，the comparison between groups was statistically significant (P<0.05). Before treatment, the classification of facial nerve function of the two groups was not significantly different (P>0.05); after 3 months of treatment and 12 months of treatment, the facial nerve function classification of the study group was significantly better than the control in 0, Ⅰ and Ⅱ level, the comparison between groups was statistically significant(P<0.05). During the 12-month follow-up, there was no recurrence and no related complications occurred in both two groups. Conclusion: Neuroendoscope combined with microscope microvascular decompression can effectively treat patients suffered from hemifacial spasm and obviously improve their facial nerve function. It is worthy of clinical application.

Key words: neuroendoscope, microscope, microvascular decompression, hemi facial spasm, facial nerve function