目的：探讨微血管减压术（MVD）治疗椎动脉（VA）相关性及非椎动脉（NVA）相关性面肌痉挛的疗效及并发症情况，同时阐明VA相关性面肌痉挛的病理生理学。方法回顾性分析本资料中的102例面肌痉挛患者，并对所有患者进行定期随访。结果 VA相关组与NVA相关组在年龄及性别方面无明显差异（P>0.05）；VA相关组左侧的比例（76.1%）明显多于NVA相关组（48.2%），有统计学差异（P=0.004）；VA相关组Smoker评分明显高于NVA相关组（P<0.001）。VA相关组整体治愈率为95.7%，术后并发症包括手术同侧不全性面瘫3例，听力下降1例，无菌性脑膜炎1例；NVA相关组整体治愈率94.6%，术后并发症包括手术同侧面瘫2例，听力下降2例，耳鸣1例，饮水呛咳2例；两组在治愈率方面疗效相似（P=0.814），并发症发生率方面无显著差异（P=0.799）。结论 MVD在治疗VA相关性及NVA相关性面肌痉挛治愈率方面疗效相似，并发症发生率无显著差异。VA相关性面肌痉挛或许与VA的延长扩张或解剖上的变异有关。%ObjectiveTo evaluate the clinicial effects and complications of hemifacial spasm associated with the vertebral artery(VA)and non-vertebral artery(NVA)after microvascular decompression,and clarify the pathophysiology of hemifacial spasm associated with the vertebral artery.MethodsThe clinical data of 102 patients with hemifacial spasm who underwent microvascular decompression from July 2011-September 2012 were retrospectively reviewed and analyzed.ResultsThere was no significant difference between the VA-associated group and the non-VA-associated group in terms of age or sex(P>0.05);In the VA-associated group,the HFS-affected side is significantly higher on the left side compared with the non-VA-associated group (P=0.004);The total Smoker’s classification score in the VA-associated group is significantly higher than that in non-VA-associated group(P<0.001). The cure rate of the VA-associated group is 95.7%,postoperative complications included facial palsy in 3 patients,hearing deficit in 1 patient,aseptic meningitis in 1 patient; The cure rate of the non-VA-associated group is 94.6%, postoperative complications included facial palsy in 2 patients,hearing deficit in 2 patients,tinnitus in 1 patient. There was no significant difference between the two groups in terms of cute rate and postoperative complications.ConclusionIn terms of the cure rate and complication,there were no significant difference between the two groups after microvascular decompression.VA-associated hemifacial spasm may be correlated with dolicoectatic VA or anatomical variation.
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