重度损害特发性面神经麻痹42例临床与神经电生理分析.docVIP

重度损害的特发性面神经麻痹42例临床与神经电生理分析 湖南省株洲市一医院神经内科 包正军 曾国华 邮编： 412000 联系电话手机） 0731[作者简介] 包正军，男（1963-）主任医师，主要从事神经内科临床与神经电生理工作。 [通讯作者] 曾国华：Email:zengwensha@yahoo.cn [摘要] 目的 分析重度损害的特发性面神经麻痹的临床、神经电生理及对预后的评价。方法 回顾性分析42例重度损害的特发性面神经麻痹患者的临床资料，使用肌电图诱发电位仪对患者在发病1个月、3个月、6个月时分别进行肌电图与神经传导速度检查，将其结果与相应时点的临床疗效进行比较。结果 42例难治性特发性面神经麻痹患者：①治疗前后神经功能的恢复无明显改善（P﹥0.05）。②患侧面神经运动神经传导速度均明显减慢，潜伏期延长，所引出的M波波幅均低于正常的70%，患侧面神经所支配的肌肉均可见失神经电位，以上4个参数结果在治疗1、3、6个月时与正常值比较均有显著差异（ P﹤0.01），不同治疗时间后比较无显著改变（ P﹥0.05）。结论 重度损害的特发性面神经麻痹患者经内科综合治疗无明显效果；神经传导速度与肌电图可以给重度损害的特发性面神经麻痹患者的预后评估提供客观的依据，且内科综合治疗6个月后面神经功能在V、VI级者，是否采取手术治疗以及手术治疗的时机选择与预后需与广大同行进一步探讨。 [关键词] 重度损害 特发性面神经麻痹 疗效 神经电生理 A study on clinic and Nerve electroneurophysiology in 42 patients with idiopathic facial palsy after severe nerve damage BAO Zheng-Jun, ZENG Guo-Hua Department of Neurology, No. 1 Hospital of Zhuzhou, Zhuzhou （412000）,Hunan China [Abstract] bOjective: To anolyze the clinic, electroneurophysiology and prognosis evaluation in patients with idiopathic facial palsy after severe nerve damage. Methods: Forty-two patients with severe nerve damage were analyzed for clinical manifestations. Nerve conduction test and EMG examination were completed and it,s results were comparted with their clinical effectiveness in all cases at 1month, 3months,6months,respectively. Results: In the 42 patients with idiopathic facial palsy after severe nerve damage: ⑴ There was no improvement in neural function recovery after therapy（P﹥0.05） ; otor nerve conduction velocity slowed, the latency prolonged ,the M wave amplitude decreased for 70% than that of normal person, and denervated potential within the muscles innervated by the facial nerve on the ill side was detected, the results of the above 4 parameters in the treatment of 1, 3 and 6 months compared with normal have significant difference（ P﹤0.01）.But different time before and after treatment had no significant change (P ﹥ 0.05).Conclusions: For patients with idiopathic fac