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目的探讨微血管减压术治疗功能性脑神经疾病的临床价值、手术中的处理选择及并发症的预防。方法采用耳后小切口微血管减压术治疗功能性脑神经疾496例,共504例次手术,三叉神经痛408例,共进行了416例次手术;面肌痉挛82例;舌咽神经痛6例。术中根据血管与神经的压迫关系分为单纯接触、袢状压迫、黏连包绕和贯穿等4型,并根据不同的压迫类型进行不同的处理。结果本组经1年以上随访,三叉神经痛第一次术后疼痛立即消失312例,明显进步59例,进步24例,无效6例,复发6例。面肌痉挛术后62例抽搐停止,19例术后仍有面部不同程度的抽搐,3例病人无效。舌咽神经痛术后疼痛均消失,无复发。结论微血管减压术治疗功能性脑神经疾病效果肯定,其疗效与血管压迫神经的类型有关。
Objective To investigate the clinical value of microvascular decompression in the treatment of functional cranial nerve diseases, the treatment options in surgery and the prevention of complications. Methods A total of 496 cases of functional cranial neuropathy were treated with small incision microvascular decompression. A total of 504 cases of subtotal surgery and 408 cases of trigeminal neuralgia were performed. A total of 416 operations were performed; 82 cases of hemifacial spasm; glossopharyngeal neuralgia 6 example. Intraoperative compression of blood vessels and nerves are divided into simple contact, sternocular compression, adhesions around and through the other 4 types, and according to different types of oppression for different treatment. Results After more than one year of follow-up, the first postoperative pain of trigeminal neuralgia disappeared immediately in 312 cases, 59 cases improved significantly, 24 cases improved, 6 cases failed and 6 cases relapsed. 62 cases of hemifacial spasm stopped seizures, 19 patients still have facial twitch in varying degrees, 3 patients ineffective. Glossopharyngeal neuralgia postoperative pain disappeared, no recurrence. Conclusion Microvascular decompression for the treatment of functional cranial nerve disease affirmation, the curative effect and type of vascular compression nerve.