异常肌反应刺激阈值定量分析在微血管减压术中的应用
Application of Quantitative Monitoring of Abnormal Muscle Response Threshold in Microvascular Decompression
杜川 1吴春晓 2董帅 3李超4
作者信息
- 1. 济南市章丘区人民医院神经外科,济南 250200
- 2. 济南市章丘区人民医院手术室,济南 250200
- 3. 济南市章丘区人民医院老年医学科,济南 250200
- 4. 山东大学齐鲁医院神经外科,济南 250012
- 折叠
摘要
目的 探究定量监测异常肌反应(AMR)阈值在面肌痉挛患者微血管减压术(MVD)疗效评估中的应用价值.方法 收集2020年1月至2021年5月收治的行MVD手术的面肌痉挛患者100例,按照随机数字表法分为对照组(50例)和观察组(50例).观察组根据术中定量监测的AMR阈值变化随时调整手术策略,并记录手术结束时的AMR阈值;对照组术中采用恒定刺激强度(30 mA)定性监测AMR,记录手术结束时AMR是否消失.比较两组患者的临床疗效,并分别比较不同疗效患者的术后AMR消失情况及AMR阈值的差异.ROC曲线分析观察组手术结束时AMR阈值在MVD术后疗效评估中的性能.结果 观察组术后临床疗效相对优于对照组(P＜0.05).对照组不同疗效患者间AMR消失与AMR未消失的分布差异有统计学意义(P＜0.05),术后AMR消失与否评估MVD术后疗效的敏感度为80.95％,特异度为62.50％.观察组不同疗效患者间AMR阈值差异有统计学意义(P＜0.05);ROC曲线显示手术结束时AMR阈值评估MVD术后疗效的AUC为0.947,敏感度为87.23％,特异度为100.00％,最佳截断值为40 mA.结论 术中定量监测AMR可有效提高面肌痉挛患者MVD的术后疗效,对术后疗效有一定评估价值.
Abstract
Aim To explore the application value of quantitative monitoring of abnormal muscle response(AMR)threshold in the evaluation of clinical effect of microvascular decompression(MVD)in patients with hemifacial spasm(HFS).Methods A total of 100 HFS patients who underwent MVD in the department of neurosurgery,Zhangqiu District People's Hospital of Jinan from January 2020 to May 2021 were collected and divided randomly into a control group(50 cases)and a observation group(50 cases).In the observation group,the surgical strategy was adjusted according to the changes of AMR threshold quantitatively monitored during surgery,and the AMR threshold at the end of surgery was recorded.While in the control group,AMR was qualitatively monitored with constant stimulus intensity(30 mA),whether AMR disappeared was at the end of the surgery was recorded.The clinical efficacy of the two groups were compared,and the AMR disappearance and the difference of AMR threshold in patients with different therapeutic effects were compared.ROC curve was used to analyze the performance of AMR threshold in the evaluation of clinical efficacy of MVD.Results The clinical efficacy of observation group was better than the control group with significant difference(P＜0.05).There was statistical difference in the distribution of AMR disappearance or not among the patients with different therapeutic effects in the control group(P＜0.05),the sensitivity and specificity of AMR disappeared or not for evaluating clinical efficacy of MVD were 80.95％and 62.50％,respectively.There was statistically difference in AMR thresholds of patients with different therapeutic effects in the observation group(P＜0.05).The ROC curve showed that the AUC of AMR threshold to evaluate the clinical efficacy of MVD was 0.947,the sensitivity and specificity were 87.23％and 100.00％,the optimal cut-off value was 40 mA.Conclusion Quantitative monitoring of AMR can effectively improve the postoperative efficacy of MVD in HFS patients,and has certain evaluation value for postoperative efficacy.
关键词
面肌痉挛/微血管减压术/异常肌反应/定量监测/疗效Key words
hemifacial spasm/microvascular decompression/abnormal muscle response/quantitative monitoring/clinical efficacy引用本文复制引用
基金项目
济南市卫生健康委科学研究计划(2021-2-123)
出版年
2024
NETL
NSTL
万方数据