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目的研究面神经麻痹患者的定量温度觉特点,分析定量温度觉与面神经麻痹预后的关系。方法选择周围性面神经麻痹患者30例,另选20例正常人作为对照,定量测定其耳前、颊部皮肤的温度觉和面神经传导速度。于患者病后2周、1个月、2个月和6个月采用House-Brackmann(H-B)评估系统评定预后。结果12例(40%)面神经麻痹患者出现QTT异常,其中8例有糖尿病(占66.7%),3例患侧局部有带状疱疹(占25%),1例病毒感染血清学检测阳性(占8.3%)。QTT异常组病后2个月和6个月的H-B评分与QTT正常组比较,差异有统计学意义(P<0.05);QTT异常组患者患侧面神经传导速度明显下降,与QTT正常组比较,差异有统计学意义(P<0.05);多元逐步回归分析发现,冷觉阈值增高与预后呈负相关。结论面神经麻痹患者QTT异常与病因和预后有一定关系,QTT异常者预后较差。
Objective To study the quantitative temperature sensory characteristics of patients with facial paralysis and to analyze the relationship between the quantitative temperature sensation and the prognosis of facial nerve palsy. Methods Thirty patients with peripheral facial paralysis and 20 normal controls were chosen as controls to measure the temperature sensation and facial nerve conduction velocity of the frontal and cheek skin. The House-Brackmann (H-B) assessment system was used to assess the prognosis at 2 weeks, 1 month, 2 months and 6 months after the patient’s illness. Results QTT abnormalities were found in 12 patients (40%) with facial paralysis, of which 8 had diabetes (66.7%), 3 had herpes zoster (25%) and 1 had positive serological tests 8.3%). Compared with QTT normal group, HBT score of 2 and 6 months after QTT abnormal group showed significant difference (P <0.05); lateral nerve conduction velocity of QTT abnormal group decreased obviously, compared with QTT normal group, The difference was statistically significant (P <0.05). Multivariate stepwise regression analysis showed that the increased chilling sensation threshold was negatively correlated with the prognosis. Conclusion QTT abnormalities in patients with facial nerve paralysis have a certain relationship with the etiology and prognosis, and the prognosis of QTT abnormalities is poor.