Bell麻痹患者的临床特征和临床预后分析

摘要

目的：总结Bell麻痹的疗效和治疗体会并探讨影响其预后的因素，为Bell麻痹的进一步防治提供科学依据。方法对2010年9月至2013年1月到我院治疗的222例Bell麻痹患者的人口学资料、临床特征及治疗情况进行回顾性统计分析。以House-Brackmann分级法作为面神经功能的评估标准。结果 Bell麻痹各年龄段均可发病，病变部分和性别分布差异均无统计学意义(P>0.05)，其中160例(72.1%)3个月后完全恢复。入院时面肌完全瘫痪，发病到接受治疗超过3 d，缓慢起病，神经电图复合肌肉运动单位(CAMP)波幅比≤30%的患者完全恢复率降低，差异有统计学意义(P<0.05)。结论发病时面瘫的严重程度、发病后就诊时间、起病方式及波幅比是判断Bell麻痹预后的重要因素。%Objective To summarize the treatment experiences and clinical efficacy of Bell's palsy (idiopath-ic facial paralysis), and to investigate the factors influencing the outcome of treatment. Methods A retrospective and epidemiological review of 222 patients with Bell's palsy admitted to our hospital from September 2010 to Janu-ary 2013 were performed. Demographic data, clinical characteristics and management were processed for statistical analysis. Facial nerve function outcomes were evaluated with House-Brackmann grading system. Results There were no significant differences of involvement in either age group, sex and lesions location (P>0.05). Among the 222 patients, 160 (72.1%) experienced complete recovery from Bell's palsy in 3 months. Patients with initial House-Brack-mann grades VI, progressive onset, electroneurographically detected degeneration of no less than 70%, and duration between onset and treatment longer than three days were shown to have poor outcome of facial function (P<0.05). Conclusion The initial severity of paralysis, the ratio of wave amplitude, the onset styles, the time of starting treat-ment are found to be important factors in predicting the prognosis of Bell's palsy.