茎乳孔和星状神经节同时注射药物治疗儿童周围性面瘫的观察护理

目的:总结茎乳孔和星状神经节同时注射药物治疗儿童周围性面瘫的观察护理体会。方法:将起病60 d内的患者列为研究对象,用茎乳孔注射药物2%利多卡因,地塞米松,Vit B12和同侧星状神经节同时注射药物2%利多卡因,地塞米松治疗,同时给予密切观察护理,指导患儿加强自我护理。结果:本组共42例,治愈42例,治愈率100%,无一例后遗症。平均治愈时间为13.5 d。效果显著。结论:茎乳孔注射药物2%利多卡因,地塞米松,Vit B12和同侧星状神经节同时注射药物2%利多卡因,地塞米松治疗面神经炎,注射时密切观察护理,同时加强自我护理,能使面神经功能较快恢复,疗效确切,且无后遗症。     

星状神经节封闭治疗面神经炎26例护理

面神经炎系指茎乳管内急性非化脓性炎症，其病因不明，多因受凉引起局部营养神经的血管痉挛、神经组织缺血、水肿、面神经受压迫所致。表现为周围性面瘫，亦称Ｂｅｌ氏麻痹［１］；而星状神经节封闭主要是切断病理过程的恶性循环，保护神经系统，同时还由于温和的刺激使组...     

经茎乳孔和星状神经节同时注射药物治疗儿童面神经炎33例

我院于 1995年 5月开始采用在面神经干出颅部位茎乳孔和同侧星状神经节 ,注射能促进神经修复和改善局部血液循环等作用的组合药物 ,治疗儿童面神经炎的新方法 ,取得良好效果 ,报告如下。1　临床资料1.1　一般资料 :本组患儿 33例 ,男 11例 ,女 2 2例 ,年龄 9～ 13岁。均为单侧病变。就诊时患儿除周围神经性面瘫的症状外 ,神经系统检查未发现其他阳性体征。其中有 3例与 9例分别经 MPI和 CT检查颅内均无异常发现。 33例患儿均无高热、外伤及手术史。1.2　注射方法 :1茎乳孔注射[1] :患儿取侧卧位 ,头偏向健侧 4 5°,穿刺点在乳突前缘上 2 /…     

临证心得透穴治疗面瘫

面瘫徐称口眼歪斜,西医称为面神经麻痹,是因茎乳孔内神经非特异性炎症所致的周围面瘫.其诱发因素可能系风寒,病毒感染,自主神经功能不稳等,引起局部神经的营养血管痉挛,导致神经缺血水肿.因骨性面神经仅能容纳面神经通过,面神经一旦发生缺血水肿,必然导致面神经受压.表现一侧表情肌完全性瘫痪,额纹消失,眼裂变大,不能闭合,患侧鼻唇变浅,口角下垂,示齿时口角歪向健侧,鼓腮漏气等.     

面神经磁运动诱发电位的颅内刺激部位

采用面神经磁运动诱发电位（MEP）测试技术，对30例正常人头颅顶枕部磁刺激。结果在同侧额肌诱发的复合肌肉动作电位（CMAPs）的潜伏期比常规在茎乳孔进行电刺激（ENOG）诱发的潜伏期长1．3±0．6ms。面神经传导速度约为50～60mm／ms，面神经自脑干发出至茎乳处的长度约为65mm，依此计算出面神经自脑干至茎乳了孔的传导时间应为1．1～1．3ms，提示面神经MEP的刺激部位在该神经自脑干发出至进入内听道口前这一段，并可能更靠近脑干端。     

星状神经节阻滞治疗偏头痛的疗效观察

目的:探讨星状神经节阻滞对偏头痛治疗效果依据。方法:28例病者采用局麻药、地塞米松、维生素B12星状神经节阻滞法,注射前后测定脑光电血流图。结果:注射后脑供血情况有明显改善(占75%),治疗前、后差异有非常显著性(P<0.01),注射侧更为显著。结论:星状神经节阻滞对治疗偏头痛是一种有效的、安全的方法,其机制可能与改善脑血液循环有关,尤其是对颈动脉系供血改善显著。     

中西医结合治疗面神经炎37例疗效观察

面神经炎是指急性非化脓性的茎乳孔内的面神经炎所致的周围面神经麻痹。其病因可能为局部营养神经的血管因受冷而发生痉挛，导致神经缺血、水肿、受压迫致病。茎乳突孔内的骨膜炎也可产生面神经肿胀、受压、血循环障碍而致神经麻痹，祖国医学称之为“口僻”，“口眼歪斜”并认为头面部经脉空虚，风邪乘虚入中经络，导致气血痹阻，面部脉络，经筋失养以致肌肉纵缓不收而发面瘫。本文运用中西医结合，使临床病例得到综合治疗，有利于患者康复。     

针刺治疗周围性面瘫经验总结

周围性面瘫即周围性面神经麻痹,多由于急性非化脓性茎乳孔内的面神经炎所引起,它使局部营养面神经的血管发生痉挛,导致面神经组织缺血、缺氧、水肿受压而致病,产生面部肌肉瘫痪的症状.     

面神经干及蝶腭神经节区药物注射治疗面神经炎的疗效观察

据研究,面神经炎通常认为是局部营养神经的血管痉挛,导致面神经组织缺血、水肿,受压而致病。病理变化早期主要为面神经水肿、髓鞘或轴突不同程度的变性。蝶腭神经节与面神经、三叉神经、植物神经系及垂体有密切联系。国内外学者研究证实封闭或刺激蝶腭神经节可治疗由植物神经系引起的多种神经血管痉挛缺血性疾病。我们应用茎乳突沟面神经干区及蝶腭神经节注射地塞米松、654—2、VitB_(12)治疗确诊的急性面神经炎(面神经麻痹)59例,治疗观察结果:痊愈53例,约占89.8％(53/59);有效5例,约占8.5％(5/59);无效1例,约占1.7％(1/59)。平均疗程20.6天。约89.8％的病例于治疗开始后2～3天即开始恢复。与国内外有关资料报道差异显著。     

星状神经节联合臂丛神经阻滞治疗乳腺癌术后上肢水肿效果观察

目的：观察星状神经节联合臂丛神经阻滞治疗乳腺癌术后上肢水肿的疗效。方法：患侧星状神经节阻滞,注入0．125％罗哌卡因8mL,每周3次,持续4周。腋窝臂丛神经阻滞,注入0．125％罗哌卡因15mL（内含得宝松1mL）。臂丛神经阻滞每周1次,持续4周。测量并比较治疗前及治疗后1、2、3、4周时双侧上肢周径差值。结果：治疗4周后双侧上肢周径差由治疗前（3．92±1．21）cm下降至（1．34±0．43）cm（P〈0．05）。患肢水肿较治疗前显著缓解。结论：星状神经节联合臂丛神经阻滞的方法可以较好地缓解乳腺癌术后患侧上肢的水肿．     

血浆胶在耳源性面神经麻痹手术治疗中的应用

手术治疗耳源性面神经麻痹8例,其中乳突手术损伤4例,慢性中耳炎(特别是胆脂瘤性中耳炎)3例,Bell's麻痹1例。作面神经水平段减压1例;垂直段减压1例;膝状节到茎乳孔减压6例。2例作了神经移植和吻合术。术中都使用了自制的血浆胶来保护、固定和粘合面神经及其吻合端,效果良好。对血浆胶的制备作了介绍,并讨论了面神经损伤的诊断和手术时机。     

The use of nerve conduction studies in determining the short-term outcome of Bell's palsy

Bell's palsy is a common neurological problem causing considerable loss of self-esteem among patients. A prospective observational study was conducted to determine the short-term outcome of Bell's palsy at 1 month and 2 months after the onset and the relationship between these outcomes with facial nerve degeneration. We also determined if gender, age, diabetes, systolic and diastolic blood pressure influence the severity of facial nerve degeneration and the clinical outcome at 2 months after the onset. After clinically grading the newly diagnosed unilateral Bell's palsy patients using the House-Brackmann facial nerve grading system, nerve conduction studies of the facial nerve were done to determine the severity of facial nerve degeneration. The recovery of the facial paralysis was clinically graded again at the end of 1 month and 2 months from the onset. A total of 37 patients were recruited. There was a strong positive correlation between facial nerve degeneration and the clinical outcome of Bell's palsy at 1 month (r = 0.794; p < 0.0005) and 2 months (r = 0.732; p < 0.0005) after the onset. There was no significant correlation between either the facial nerve degeneration or the clinical outcome at 2 months with the patients' age (p = 0.288 and p = 0.799 respectively), systolic blood pressure (p = 0.425 and p = 0.933 respectively) or diastolic blood pressure (p = 0.243 and p = 0.579 respectively). Neither the severity of facial nerve degeneration nor the clinical outcome at 2 months were significantly different between male and female patients (p = 0.460 and p = 0.725 respectively) or diabetic and non-diabetic patients (p = 0.655 and p = 0.655 respectively).     

腮腺摘除术中寻找面神经主干的新途径

<正> 在腮腺摘除术中不损伤面神经,早已成为颌面外科领域中的一个重要问题。临床在进行腮腺摘除术时,对于腮腺浅叶和位于面神经表面的腮腺良性和低度恶性肿瘤,根据肿瘤所在的部位和移动性,一般采用两种不同的方法来解剖面神经以摘除腮腺:即先找面神经主干,然后再循主干向远端分离分支;或先找面神经分支,再循此而至主干。由于面神经主干位置较深,加之其支配范围     

病毒感染性面神经麻痹的实验探讨

目的 探讨贝尔氏面神经麻痹与单纯疱疹病毒(HSV)感染的关系.方法 将HSV接种在120只Bal b/c小鼠耳廓背面制作面神经麻痹实验模型.应用荧光抗体法和酶抗体法检测其中32只小鼠的HSV抗原.结果 面神经麻痹发生率65%(75/120),只在接种侧检出HSV抗原,间接荧光抗体法和酶抗体法检测的32只小鼠中19只检出病毒抗原.瞬目反射诱发肌活动电位,麻痹组麻痹侧I渡潜伏期平均(14.3±2.4)ms;非麻痹侧I波潜伏期平均(7.2±3.6)ms,两侧比较差异有统计学意义(t=5.267,P<0.01).结论 HSV感染可能是贝尔氏面神经麻痹的病因之一.     

Recurrent Bell's palsy in a young woman

Bell's palsy is a benign lower motor neuron facial nerve disorder. It is almost always unilateral. We report a 20-year-old nulliparous woman with five episodes of recurrent Bell's palsy. A review of recent medical literature revealed a paucity of case reports involving an individual with five episodes of recurrent Bell's palsy, with none found in Asian neurology medical literature. Despite the multiple episodes of Bell's palsy recurrences, the patient did not suffer much neurological sequelae from the disease.     

成年及新生大鼠面神经结扎后NADPH-d阳性神经元的不同表达

目的: 研究新生及成年大鼠面神经结扎后,面神经核运动神经元(FMN)NADPH-d阳性细胞的动态变化. 方法: 于新生及成年大鼠茎乳孔处结扎面神经,于3, 7, 14, 21, 28, 56, 84 d采用NADPH-d组织化学方法观察NADPH-d阳性细胞在面神经核中的变化. 并观察NADPH-d阳性细胞与存活神经元之间的关系. 结果: 成年大鼠面神经结扎FMN受损后,3 d～12 wk NADPH-d阳性持续表达. 但是幼年大鼠面神经结扎FMN受损后1 wk,NADPH-d阳性方可在损伤侧观察到,至8 wk则几乎观察不到NADPH-d阳性FMN. 结论: 面神经损伤后,成年及新生大鼠损伤侧NADPH-d阳性FMN数目均有所增加,但是它们在表达时程上显示了不同的模式.     

Blink reflex and discomplete facial nerve palsy

BACKGROUND: Electrophysiologic findings of the blink reflex in patients with Bell's palsy are usually said to be either prolonged latencies and/or absent early and middle responses of it. METHODS: Facial nerve conduction and blink reflex studies were performed on a 42-year-old male patient with right-side Bell's palsy. Studies were done using protocols previously validated and published elsewhere. RESULTS: The right compound muscle action potential was not found after stimulation of the right facial nerve as expected. Absence of the short (R1) and middle (R2) responses of the blink reflex were also noted after right and left supraorbital nerve stimulation. Further, the late (R3) response of the blink reflex was displayed on the abnormal side when electrical stimuli were applied to the right supraorbital nerve while the patient attempted to perform voluntary movement of the paralyzed facial muscles including eye closing. CONCLUSIONS: The recording of R3-a late response following fibers and using motoneurons other than those employed by R1 and R2-on the paralyzed side after performing some reinforcement maneuvers allows us to suggest that, in some facial nerve palsies, there are some structures remaining alive that may be useful for carrying out a more timely and accurate diagnosis and follow-up.     

家兔急性实验性面神经损伤的组织病理观察

目的 观察家兔面神经急性损伤后髓鞘和轴索的组织病理变化。方法 用丝线结扎茎乳孔以外的面神经总干，观察结扎后1天、3天及5天面神经的组织病理改变；结果 家兔面神经受损后，先后在髓鞘和轴索结扎天数的增加，面神经损伤亦呈加重的趋势。     

面神经逆行诱发电位刺激方法的探讨

①目的 探讨采用极性交替的电刺激方法逆行诱发电位刺激伪迹减小的可行性。②方法 刺激面神经外周分支，在健康家猫鼓膜记录面神经逆行诱发电位。③结果 在鼓膜记录到面神经逆行诱发电位受刺激伪迹影响减小，而不影响面神经逆行诱发电位的波形。④结论 采用极性交替的电刺激方法，记录面神经逆行诱发电位，既可减小了刺激伪迹，也不影响其波形，互便于结果分析、可在人体面神经逆行诱发电位检查中推广应用。     

瞬目反射和面神经传导检测在Bell麻痹中的运用价值

目的:探讨瞬目反射和面神经传导检测在Bell麻痹患者的早期诊断和预后评估中的价值。方法:对39例Bell麻痹患者在病程为3 d(A组)和4～10 d(B组)时分别进行BR(Blink Reflex)、FNC(Facial Nerve Conduction)检测,3个月(C组)后复查。结果:R1﹑R2﹑R2'波缺失者24例预后较差,仅15例患侧较健侧各波延长者预后较好,其中R1/M潜伏期比值提示27例表现为茎乳孔内段损害,7例为外段损害,5例较大范围受累。结论:BR、FNC检测可客观地评价面神经损害的程度及部位,对临床诊断及预后有指导意义。