Objective: To investigate whether the short-term relief of spasm (within 7 days) after microvascular decompression (MVD) for hemifacial spasm (HFS) can be used as a prognostic factor of long-term outcome (>6 months). Methods: The clinical characteristics and follow-up data (completely recorded) of 159 patients who had HFS and underwent microvascular decompression surgery in the first Affiliated Hospital of Fujian Medical University from August 2008 to May 2016 were analyzed retrospectively. The collected data focus on symptom relief in a time course: immediately after MVD, 7 days after MVD and the last follow-up (>6 months) by using Cohen-Albert grading. Results: In a total of 159 patients underwent MVD were followed up for more than 6 months.Compared to persist spasm group within 7 days after MVD, the cure rate was significantly higher in the spasm symptom relief group within 7 days after MVD (P<0.05). The cure rate of MVD (y) and the number of days within 7 days of relief (x) were highly relevant, y=-0.707x(2)+ 9.724x+ 67.442 (P<0.05). By using univariate Logistic regression analysis, we found that the prognostic factors of long-term curative effect were the symptom scale immediately after MVD and the average symptom scale in the 7 days after MVD (P<0.001). The incidence of delayed cure was 41.5%(66/159). Conclusion: In the 7 days after MVD, at least 1 day of symptom remission can predict the cure of HFS.
目的： 探讨面肌痉挛(HFS)微血管减压术(MVD)后短期缓解(7 d内)能否作为长期疗效(>6个月)的预测因素。 方法： 回顾性分析福建医科大学附属第一医院从2008年8月至2016年5月间行MVD术的159例面肌痉挛患者的病历资料，记录患者术后即刻至术后7 d、最近1次随访时(>6个月)的症状分级(Cohen Albert标准)及有无迟发性治愈发生。 结果： 159例HFS患者行MVD术，术后7 d内观察到缓解的患者的治愈率显著高于术后7 d持续抽搐组(P<0.05)，且HFS术后患者治愈率(y)和7 d内缓解的天数(x)高度正相关，y＝－0.707x(2)＋9.724x＋67.442(P<0.05)。对术后7 d疗效和最后一次随访时疗效的相关预后因素进行Logistic回归分析后，发现术后即刻症状分级和术后7 d平均症状分级为预后相关因素(P<0.001)，迟发性治愈的发生率41.5%(66/159)。 结论： MVD术后7 d内至少有1 d观察到抽搐缓解即预测着术后的治愈。.
Keywords: Delayed resolution; Hemifacial spasm; Immediately resolution; Microvascular decompression; Prognostic factor.