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Received:March 19, 2022 Published Online:January 20, 2023
Received:March 19, 2022 Published Online:January 20, 2023
中文摘要: 目的探讨影响微血管减压术治疗椎动脉相关性面肌痉挛患者术后疗效的危险因素。
方法以2018年6月至2019年6月在南京大学医学院附属鼓楼医院神经外科采用显微镜下微血管减压术治疗椎动脉相关性面肌痉挛的102例患者为对象，进行回顾性研究。根据术后随访是否痊愈分为痊愈组（84例）和未痊愈组（18例）。比较两组患者的相关临床资料，采用logistic回归分析与术后未痊愈相关的独立危险因素。
结果术后，2例患者无效，4例复发，12例缓解，84例痊愈，总有效率为94.1%;术前的后颅窝夹角、双侧椎动脉共同压迫面神经与术后未痊愈的发生相关（P＜0.05）。Logistic回归分析结果显示，双侧椎动脉参与压迫（OR=3.791，95%CI：1.132～12.698,P=0.031）及术前的后颅窝夹角大（OR=1.194，95%CI：1.048～1.361，P=0.008）是术后未痊愈的独立危险因素。
结论椎动脉相关性面肌痉挛患者术后未痊愈的影响因素包括术前的后颅窝夹角大小和双侧椎动脉共同参与压迫面神经。
Abstract:ObjectiveToexploretheriskfactorsforpostoperativecurativeeffectofmicrovasculardecompression（MVD）inpatientswithvertebralartery-associatedhemifacialspasm.
MethodsAretrospectivestudywasconductedon102patientswithvertebralarteryrelatedfacialspasmwhoweretreatedbyMVDundermicroscopeintheNeurosurgeryDepartmentofDrumTowerHospitalaffiliatedtoNanjingUniversityMedicalSchoolfromJune2018toJune2019.Accordingtowhetherthepatientswerecuredornot,theyweredividedintorecoveredgroup（84cases）andnon-recoveredgroup（18cases）.Theclinicaldataofthetwogroupswerecompared,andtheindependentriskfactorsrelatedtopostoperativenonrecoverywereanalyzedbylogisticregression.
ResultsThepostoperativeeffectsincluded2casesofinefficacy,4casesofrecurrence,12casesofremissionand84casesofrecovery,withatotaleffectiverateof94.1%.Thepreoperativeposteriorcranialfossaangleandco-compressionoffacialnervebybilateralvertebralarterieswererelatedtouncuredafteroperation(P<0.05).Logisticregressionanalysisshowedthatbilateralvertebralarterycompression(OR=3.791,95%CI1.132-12.698,P=0.031)andpreoperativelargerposteriorfossaangle(OR=1.194,95%CI1.048-1.361,P=0.008)wereindependentriskfactorsforpostoperativenon-recovering.
ConclusionTheinfluencingfactorsofnon-recoveringpostoperativehemifacialmusclespasminpatientswithvertebralartery-associatedhemifacialspasmincludethesizeoftheposteriorcranialfossaanglebeforesurgeryandthejointinvolvementofbilateralvertebralarteriesincompressingthefacialnerve.
文章编号： 中图分类号：R745.12 文献标志码：B
基金项目:南京大学现代医院管理与发展研究所课题（NDYG2021052）
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