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瞬目反射与面神经运动传导检测对特发性面神经麻痹早期诊断和预后评估的价值
引用本文:杨轩,邱海斌,周雪贤,梁艳桂. 瞬目反射与面神经运动传导检测对特发性面神经麻痹早期诊断和预后评估的价值[J]. 中国临床神经外科杂志, 2022, 27(6): 474-476. DOI: 10.13798/j.issn.1009-153X.2022.06.013
作者姓名:杨轩  邱海斌  周雪贤  梁艳桂
作者单位:528000 广东,佛山市中医院肌电图室(杨轩、邱海斌、周雪贤),神经内科(梁艳桂)
摘    要:目的 探讨瞬目反射(BR)与面神经运动传导(FMC)检测对特发性面神经麻痹早期诊断和预后评估的价值。方法选取2019年9月至2020年9月收治的特发性面神经麻痹100例。发病1~7 d,BR记录R1、R2及R2’波,分为出波组和未出波组;FMC检测复合肌肉动作电位(CMAP),分为正常组和异常组。结果 BR检测显示,患侧R1、R2及R2’波未出波率分别为42.00%、30.00%、30.00%,均明显高于健侧(均为0.00%;P<0.05)。出波者患侧R1、R2及R2’波潜伏期较健侧均明显延长(P<0.05)。FMC检测显示,患侧CMAP潜伏期较健侧均明显延长(P<0.05)。治疗1、2、3个月的痊愈率分别为47.0%、74.0%、90.0%;BR出波组治疗1、2、3个月痊愈率明显高于未出波组(P<0.05);CMAP正常组治疗1、2、3个月痊愈率明显高于异常组(P<0.05)。结论 BR与FMC检测可作为早期诊断特发性面神经麻痹的客观指标,BR出波情况与CMAP下降幅度可客观评估病人预后情况。

关 键 词:特发性面神经麻痹  瞬目反射  面神经运动传导  复合肌肉动作电位  早期诊断  预后评估

Application of blink reflex and facial nerve motor conduction to the early diagnosis and prognosis evaluation of patients with idiopathic facial nerve palsy
YANG Xuan1,QIU Hai-bin1,ZHOU Xue-xian1,LIANG Yan-gui2. Application of blink reflex and facial nerve motor conduction to the early diagnosis and prognosis evaluation of patients with idiopathic facial nerve palsy[J]. Chinese Journal of Clinical Neurosurgery, 2022, 27(6): 474-476. DOI: 10.13798/j.issn.1009-153X.2022.06.013
Authors:YANG Xuan1  QIU Hai-bin1  ZHOU Xue-xian1  LIANG Yan-gui2
Affiliation:1.Department of EMG Room, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China; 2.Department of Neurology, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China
Abstract:Objective To investigate the value of blink reflex (BR) and facial motor conduction (FMC) in the early diagnosis and prognosis evaluation of patients with idiopathic facial paralysis (IFP). Methods A total of 100 patients with IFP were recruited from September 2019 to September 2020. Within 1 to 7 days after the onset, R1, R2 and R2’ waves were recorded using BR test, and they were divided into wave group and no-wave group; compound muscle action potentials (CMAP) were recorded using FMC test and they were divided into normal group and abnormal group. Results BR test showed that the rates of no R1, R2 and R2’ waves on the affected side were 42.00%, 30.00% and 30.00%, respectively, which were significantly higher than those on the healthy side (0.00%; P<0.05). The latencies of R1, R2 and R2’ waves on the affected side were significantly longer than those on the healthy side (P<0.05). FMC test showed that the CMAP latency of the affected side was significantly longer than that of the healthy side (P<0.05). The cure rates of 1, 2, and 3 months after treatment were 47.0%, 74.0%, and 90.0%, respectively. The cure rates 1, 2, and 3 months after treatment in the wave group were significantly higher than those in no-wave group (P<0.05). The rates 1, 2 and 3 months after treatment in the normal group were significantly higher than those in the abnormal group (P<0.05). Conclusions BR and FMC can be used as objective tests for the early diagnosis of patients with IFP, and they also can be objectively used to evaluate the prognosis of patients with IFP.
Keywords:Idiopathic facial paralysis   Blink reflex   Facial nerve motor conductio   Early diagnosis   Prognosis
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