电生理监测在面肌痉挛微血管减压术中的作用

目的 评价异常肌反应(Abnormal muscle response,AMR)监测在面肌痉挛微血管减压术(Microvascular decompression,MVD)中的作用.方法 回顾性分析在我科接受治疗的241例典型面肌痉挛患者临床资料并检索数据库中关于AMR监测与面肌痉挛MVD手术疗效关系的临床研究文章,采用RevMan 5.1荟萃分析软件进行分析,对AMR变化程度与术后疗效关系采用优势比(Odds ratio,OR)进行评价.结果 A组(AMR完全消失或波幅下降超过80％),B组的手术有效率分别为96.2％,82.1％,组间差异具有统计学意义(P＜0.05)；荟萃分析显示AMR消失组的术后治愈率是AMR未消失组的3.53倍[OR=3.53,95％置信区间95％CI(2.28,5.48)].结论 面肌痉李微血管减压术中行AMR监测可有效指导手术,提高手术治愈率,应将AMR作为MVD术中常规监测项目.

The role of electromyographic monitoring on microvascular decompression for hemifacial spasm

Objective To evaluate the validity of abnormal muscle response （AMR） monitoring during microvascular decompression surgery （MVD） in hemifacial spasm（HFS） patients. Methods 241 bemifacial spasm （HFS） patients with AMR monitoring during MVD were studied retrospectively＂ and literatures about AMR monitoring during MVD were identified from the relevant databases. The statisti- cal analysis was conducted by the software of RevMan 5.1 ,odds ratio（OR） of the relation between the change of AMR during MVD and the clinical outcomes after surgery were calculated. Results 96. 2~ and 82.1~ patients were relived from hemifacial spasm respectively in A group （AMR complete--disap- peared） and B group respectively. The difference between the two groups was statistically significant. Meta--analysis revealed that the chance of a cure of HFS if the AMR disappeared during surgery was 3.53 times greater than if the AMR persisted. Conclusions AMR monitoring during MVD can be very useful in guiding surgery procedures therefore improving the outcomes of the surgery. It is recommended to be applied routinely during MVD.