微血管减压术治疗面肌痉挛：血管病理学、长期治疗效果及安全性的系统评价
Microvascular decompression for hemifacial spasm: A systematic review of vascular pathology, long term treatment efficacy and safety.
作者信息
Sharma Ravi, Garg Kanwaljeet, Agarwal Samagra, Agarwal Deepak, Chandra P Sarat, Kale Shashank S, Sharma Bhawani S, Mahapatra Ashok K
机构信息
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Neurol India. 2017 May-Jun;65(3):493-505. doi: 10.4103/neuroindia.NI_1166_16.
INTRODUCTION
Hemifacial spasm (HS) is a rare disorder caused by the compression of facial nerve root exit zone (REZ) at the brainstem by a vascular loop. Microvascular decompression (MVD) is a popular treatment modality for HS.
OBJECTIVE
The purpose of this study was to determine the long-term efficacy and safety of MVD for HS by assessing the effect of the procedure from the literature published over the last 25 years.
MATERIALS AND METHODS
A systematic data review from 1992 to 2015 using specific eligibility criteria yielded 27 studies on MVD for HS, the data of which were pooled and subjected to a meta-analysis.
RESULTS
The pooled odds ratio (OR) revealed by the meta-analysis showed that anterior inferior cerebellar artery was the most common offending vessel in 37.8% (95% confidence interval [CI]: 27.8-47.7%) of the patients. Complete resolution of HS was seen in 88.5% (95% CI: 86.7-90.4%) of the patients after a long-term follow up. The complication rate was low following MVD, the most common being temporary facial paresis in 5.9% (95% CI: 4.3-7.5%) of patients.
CONCLUSIONS
MVD is a safe and effective treatment for HS with long-term benefits and a low complication rate.
引言
面肌痉挛（HS）是一种罕见的疾病，由血管襻对脑干面神经根部出口区（REZ）的压迫所致。微血管减压术（MVD）是治疗HS的一种常用方法。
目的
本研究旨在通过评估过去25年发表的文献中该手术的效果，确定MVD治疗HS的长期疗效和安全性。
材料与方法
采用特定纳入标准对1992年至2015年的数据进行系统回顾，筛选出27项关于MVD治疗HS的研究，汇总这些数据并进行荟萃分析。
结果
荟萃分析得出的合并比值比（OR）显示，37.8%（95%置信区间[CI]：27.8 - 47.7%）的患者中，小脑下前动脉是最常见的责任血管。长期随访后，88.5%（95% CI：86.7 - 90.4%）的患者面肌痉挛完全缓解。MVD术后并发症发生率较低，最常见的是5.9%（95% CI：4.3 - 7.5%）的患者出现暂时性面瘫。
结论
MVD是一种治疗HS的安全有效的方法，具有长期疗效且并发症发生率低。
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