贝尔麻痹诊断与治疗时机的研究

目的 :探讨贝尔麻痹的定位诊断及瞬目反射 (blink reflex,BR)、神经电图 (electroneurogram,ENo G)测试结果与预后的关系和治疗时机的选择。方法 :对 36例贝尔麻痹患者进行定位诊断、BR、ENo G测试 ,并对面肌功能进行评分。结果 :对定位诊断病变在 D段 ,面肌功能评分在 1 1分以下 ,BR及 ENo G测试显示面肌功能差的患者行保守治疗效果差 ,而行面神经减压术后可望提高疗效 ,发病 1月内检查结果与预后一致 (P>0 .0 5)。结论 :对临床上定位诊断病变在D段以下 ,面肌功能评分在 1 1分以上 ,发病后 1月内 BR测试 R1 波存在及 ENo G测试面肌纤维损失 <90 %的患者 ,保守治疗可完全恢复 ;反之 ,效果就差。对保守治疗无效者 ,必须行面神经减压术。

Study on level diagnosis and therapeutic opportunity of Bell palsy

Objective:To discuss level diagnosis and therapeutic opportunity of Bell palsy.Methods:Level diagnosis,blink reflex(BR),electroneuronography(ENoG),and facial function score were made in 36 patients with Bell palsy.Results:Patients with score<11,lesion at D segment,and bad results by BR and EnoG tests appeared poor therapeutic efficacy of conservative treatment,whereas facial nerve decompression could improve the curative effect.There was a good relation between the examination results in 1 month and the prognosis.Conclusion:Patients might be quite recovered after conservative treatment with following manifestations:diagnostic lesion under D segment,facial function score>11,R 1 wave existing by BR test,and neurofiber loss<90% by ENoG within 1 month;and vice versa.Facial nerve decompression should be performed for patients with inefficient conservative treatment.