肌电图在面肌痉挛病因诊断中的临床应用价值
发布时间：2018-10-24 17:24
【摘要】：目的通过对2014年10月至2015年10月来我院进行治疗的面肌痉挛患者进行回顾性分析,探究肌电图在面肌痉挛病因诊断中的临床应用价值。方法选取2014年10月至2015年10月来我院接受治疗的43例面肌痉挛患者作为研究对象,临床诊断标准参考面肌痉挛的诊断标准。依据标准选择病例,最后纳入30例患者。应用肌电图技术检测面肌痉挛患者的面神经传导潜伏期、波幅、瞬目反射及面神经支配肌肉电活动,并与颅脑MR颅神经扫描3D-TOF成像对比,观察面神经与血管的毗邻关系以及敏感性及特异性。EMG检查分为神经传导检查和面肌肌电图检测两部分。前者(电极置于耳前方)指对面神经电刺激,从而记录神经或肌肉电活动。后者指将针极置于肌肉中或表面电极贴于面部肌肉皮肤上(口轮匝肌上唇处、额肌、眼轮匝肌)记录其电活动。结果1、30例患者中瞬目反射的早反应(R1)和晚反应(R2、R2’)的潜伏期和波幅与健侧相比无明显差异,患者患侧晚反应波幅明显高于健侧,但仅仅是刺激同侧的晚反应差异具有统计学意义(P0.05)。2、30例面肌痉挛患者在放松状态下,眼轮匝肌健侧和患侧的MF值分别为(71.2±20.3)Hz和(69.4±17.7)Hz,二者相比,基本一致(P0.05);健侧和患侧的MPF值分别为(97.6±21.4)Hz和(93.5±17.2)Hz,二者相比,基本一致(P0.05);健侧和患侧的EMG值分别为(5.1±3.1)m V和(6.8±4.3)m V,二者相比,患侧明显高于健侧,差异有统计学意义(P0.05)。3、30例面肌痉挛患者在收缩状态下,眼轮匝肌健侧和患侧的MF值分别为(103.2±16.4)Hz和(94.2±15.3)Hz,二者相比,健侧明显高于患侧,差异有统计学意义(P0.05);健侧和患侧的MPF值分别为(124.3±16.3)Hz和(112.4±14.6)Hz,健侧明显高于患侧,差异有统计学意义(P0.05);健侧和患侧的EMG值分别为(47.2±41.2)m V和(36.3±26.4)m V,二者相比,健侧明显高于患侧,差异有统计学意义(P0.05)4、通过对30例面肌痉挛患者行颅脑MR颅神经扫描3D-TOF成像,检查血管与神经的毗邻关系,发现患侧有6例为可疑接触,15例为明确接触或压迫,阳性率为70.0%(21/30),健侧有3例为可疑接触,3例为明确接触或压迫,阳性率为20.0%(6/30),二者相比,患侧阳性率明显高于健侧,差异有统计学意义(P0.01)。5、通过对30例面肌痉挛患者同时行颅脑MR检查和肌电图检查发现,30例患者中,肌电图异常者23例,阳性率为76.7%(23/30),颅脑MR异常者21例,阳性率为70.0%(21/30),两者同时异常者15例,阳性率为50.0%(15/30)。结论肌电图在血管压迫性面肌痉挛的病因诊断中有着重要的应用价值,能够为临床治疗提供可靠的参考依据,可以在临床医学中得以广泛地推广应用。
[Abstract]:Objective to explore the clinical value of electromyography (EMG) in the etiological diagnosis of hemifacial spasm by retrospective analysis of hemifacial spasm patients who were treated in our hospital from October 2014 to October 2015. Methods from October 2014 to October 2015, 43 patients with hemifacial spasm received treatment in our hospital were selected as the study object. The clinical diagnostic criteria for hemifacial spasm were referred to the diagnostic criteria of hemifacial spasm. Cases were selected according to the criteria, and 30 patients were included. The latent period of facial nerve conduction, amplitude of wave, blink reflex and innervation of facial nerve were measured by electromyography in patients with hemifacial spasm, and compared with cranial nerve scanning 3D-TOF imaging of craniocerebral MR. The relationship between facial nerve and blood vessel and its sensitivity and specificity were observed. EMG was divided into two parts: nerve conduction test and facial electromyography. The former (electrode placed in front of the ear) refers to the electrical stimulation of the facial nerve, thereby recording the electrical activity of the nerve or muscle. The latter refers to placing the needle pole in the muscle or the surface electrode attached to the facial muscle skin (upper lip, frontal muscle, orbicularis oculi) to record its electrical activity. Results 1There was no significant difference in latency and amplitude of early response (R1) and late response (R2nR2') between 30 patients with blink reflex and healthy side. The amplitude of late response in affected side was significantly higher than that in healthy side. However, the difference of late response was statistically significant only for ipsilateral stimulation (P0.05). The MF values of the healthy and affected sides of orbicularis oculi muscle were (71.2 卤20.3) Hz and (69.4 卤17.7) Hz, respectively, in 230 patients with hemifacial spasm in relaxed state, and the MF values of normal side and affected side of orbicularis oculi muscle were (71.2 卤20.3) Hz and (69.4 卤17.7) Hz, respectively. The MPF values of the healthy side and the affected side were (97.6 卤21.4) Hz and (93.5 卤17.2) Hz, respectively (P0.05), the EMG values of the healthy side and the affected side were (5.1 卤3.1) m V and (6.8 卤4.3) m V, respectively. The difference was statistically significant (P0.05). The MF values of the healthy side and the affected side of orbicularis oculi muscle were (103.2 卤16.4) Hz and (94.2 卤15.3) Hz, respectively, in 30 patients with hemifacial spasm in the contractile state, and the healthy side was significantly higher than the affected side. The MPF values of the healthy side and the affected side were (124.3 卤16.3) Hz and (112.4 卤14.60) Hz, respectively, which were significantly higher than those of the affected side (P0.05), the EMG values of the healthy side and the affected side were (47.2 卤41.2) m V) and (36.3 卤26.4) m V,), respectively, and the healthy side was significantly higher than the affected side. The difference was statistically significant (P0.05) 4. The cranial nerve of 30 patients with hemifacial spasm was examined by MR cranial nerve scanning 3D-TOF imaging. It was found that 6 cases had suspicious contact, 15 cases had definite contact or compression, and 6 cases had suspicious contact, 15 cases had definite contact or compression, 6 cases had suspicious contact, 15 cases had definite contact or compression. The positive rate was 70.0% (21 / 30). The positive rate was 20.0% (6 / 30) in the healthy side, 3 cases in the healthy side and 3 cases in the definite contact or compression. The positive rate of the affected side was significantly higher than that of the healthy side. 5The difference was statistically significant (P0.01). 30 cases of hemifacial spasm were examined by craniocerebral MR and electromyography. Among the 30 cases, 23 cases were abnormal in electromyography, the positive rate was 76.7% (23 / 30), and 21 cases were abnormal in craniocerebral MR. The positive rate was 70.0% (21 / 30), 15 cases were abnormal at the same time, the positive rate was 50.0% (15 / 30). Conclusion EMG has important application value in the etiological diagnosis of vascular compression hemifacial spasm, which can provide reliable reference for clinical treatment and can be widely used in clinical medicine.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R745.12
本文编号：2292050
[Abstract]:Objective to explore the clinical value of electromyography (EMG) in the etiological diagnosis of hemifacial spasm by retrospective analysis of hemifacial spasm patients who were treated in our hospital from October 2014 to October 2015. Methods from October 2014 to October 2015, 43 patients with hemifacial spasm received treatment in our hospital were selected as the study object. The clinical diagnostic criteria for hemifacial spasm were referred to the diagnostic criteria of hemifacial spasm. Cases were selected according to the criteria, and 30 patients were included. The latent period of facial nerve conduction, amplitude of wave, blink reflex and innervation of facial nerve were measured by electromyography in patients with hemifacial spasm, and compared with cranial nerve scanning 3D-TOF imaging of craniocerebral MR. The relationship between facial nerve and blood vessel and its sensitivity and specificity were observed. EMG was divided into two parts: nerve conduction test and facial electromyography. The former (electrode placed in front of the ear) refers to the electrical stimulation of the facial nerve, thereby recording the electrical activity of the nerve or muscle. The latter refers to placing the needle pole in the muscle or the surface electrode attached to the facial muscle skin (upper lip, frontal muscle, orbicularis oculi) to record its electrical activity. Results 1There was no significant difference in latency and amplitude of early response (R1) and late response (R2nR2') between 30 patients with blink reflex and healthy side. The amplitude of late response in affected side was significantly higher than that in healthy side. However, the difference of late response was statistically significant only for ipsilateral stimulation (P0.05). The MF values of the healthy and affected sides of orbicularis oculi muscle were (71.2 卤20.3) Hz and (69.4 卤17.7) Hz, respectively, in 230 patients with hemifacial spasm in relaxed state, and the MF values of normal side and affected side of orbicularis oculi muscle were (71.2 卤20.3) Hz and (69.4 卤17.7) Hz, respectively. The MPF values of the healthy side and the affected side were (97.6 卤21.4) Hz and (93.5 卤17.2) Hz, respectively (P0.05), the EMG values of the healthy side and the affected side were (5.1 卤3.1) m V and (6.8 卤4.3) m V, respectively. The difference was statistically significant (P0.05). The MF values of the healthy side and the affected side of orbicularis oculi muscle were (103.2 卤16.4) Hz and (94.2 卤15.3) Hz, respectively, in 30 patients with hemifacial spasm in the contractile state, and the healthy side was significantly higher than the affected side. The MPF values of the healthy side and the affected side were (124.3 卤16.3) Hz and (112.4 卤14.60) Hz, respectively, which were significantly higher than those of the affected side (P0.05), the EMG values of the healthy side and the affected side were (47.2 卤41.2) m V) and (36.3 卤26.4) m V,), respectively, and the healthy side was significantly higher than the affected side. The difference was statistically significant (P0.05) 4. The cranial nerve of 30 patients with hemifacial spasm was examined by MR cranial nerve scanning 3D-TOF imaging. It was found that 6 cases had suspicious contact, 15 cases had definite contact or compression, and 6 cases had suspicious contact, 15 cases had definite contact or compression, 6 cases had suspicious contact, 15 cases had definite contact or compression. The positive rate was 70.0% (21 / 30). The positive rate was 20.0% (6 / 30) in the healthy side, 3 cases in the healthy side and 3 cases in the definite contact or compression. The positive rate of the affected side was significantly higher than that of the healthy side. 5The difference was statistically significant (P0.01). 30 cases of hemifacial spasm were examined by craniocerebral MR and electromyography. Among the 30 cases, 23 cases were abnormal in electromyography, the positive rate was 76.7% (23 / 30), and 21 cases were abnormal in craniocerebral MR. The positive rate was 70.0% (21 / 30), 15 cases were abnormal at the same time, the positive rate was 50.0% (15 / 30). Conclusion EMG has important application value in the etiological diagnosis of vascular compression hemifacial spasm, which can provide reliable reference for clinical treatment and can be widely used in clinical medicine.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R745.12
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