张书光^1,,
李俊¹,
何鑫²,
张鑫宇²,
宋清伟³,
周密⁴,
李阳¹,
位振清^1,,
1. 大连医科大学附属第一医院 神经外科，辽宁 大连 116011
2. 大连医科大学 研究生院，辽宁 大连 116044
3. 大连医科大学附属第一医院 放射科，辽宁 大连 116011
4. 大连医科大学附属第一医院 诱发电位室，辽宁 大连 116011

基金项目: 大连市医学科研计划项目（1912025）；大连市科技创新基金计划项目（2018J13SN097）


详细信息 作者简介: 张书光（1995-），男，住院医师。E-mail：dlyzsg@126.com








通讯作者: 位振清，主任医师。E-mail：weizhqdl@126.com 中图分类号: R651.3


摘要:目的研究无牵拉技术在微血管减压术（MVD）中的安全性和有效性。方法回顾性分析于大连医科大学附属第一医院同一治疗组行MVD治疗的165例患者的临床资料。根据术中是否使用脑牵开器分为无牵开器组（87例）和牵开器组（78例），均采用乙状窦后入路，分析两组患者手术效果及术后并发症情况。结果两组患者在手术时间和疗效方面差异无统计学意义（均P＞0.05）。牵开器组28例（35.9%）、无牵开器组16例（18.4%）患者出现面部麻木、面瘫、听力障碍、头晕症状，两组间差异有统计学意义（P＜0.05）。牵开器组4例（5.1%）发生脑牵拉损伤，无牵开器组无一例发生。两组均未报告死亡病例。结论无牵拉技术辅助下行MVD的手术损伤小，可有效保护病人神经功能并降低手术并发症的风险。
关键词: 微血管减压术/
无牵拉技术/
并发症


Abstract:ObjectiveTo investigate the safety and efficacy of retractorless technique in microvascular decompression (MVD) surgery.MethodsThe clinical data of 165 patients treated with microvascular decompression by physicians in the same treatment group in the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed. According to whether the brain retractor was used during surgery, the patients were divided into retractorless group (87 cases) and retractor group (78 cases). A retrosigmoid approach was adopted in all patients. The surgical outcomes and postoperative complications in two groups of patients were analyzed.ResultsThere were no significant differences in operation time and postoperative efficacy (all P＞0.05). There were 28 patients (35.9%) in the retractor group and 16 patients (18.4%) in the retractorless group experienced facial numbness, facial paralysis, hearing impairment, and dizziness; the difference between the two groups was statistically significant (P＜0.05). There were 4 cases (5.1%) of brain traction injury in the retractor group, and none in the retractorless group. Neither group reported any death.ConclusionMicrovascular decompression with retractorless technique has less surgical trauma, and can effectively protect patients' nerve function and reduce the risk of surgical complications.
Keywords:microvascular decompression/
retractorless technique/
complication

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https://journal.dmu.edu.cn/data/article/export-pdf?id=65645f41fa89b26c22aba8d2