| Objective: This paper uses meta-analysis to evaluate the relationship between the monitoring results of abnormal muscle response(AMR)and the short-term and long-term effects after microvascular decompression(MVD)in the treatment of primary facial spasm(HFS)and analyze the relevant factors of AMR.Methods: We searched CNKI,Wanfang,VIP,Pub Med,EMBASE,Ovid,web of science databases,and collected the published literature on the judgement value of AMR disappearance in MVD surgery for patients with primary HFS before February 2020.According to the principles of PICOS,the inclusion and exclusion criteria were established and the literature was screened.The quality of studys was evaluated by the use of the Neweastle-Ottawa Scale.We extracted the relevant data.In this study,"short term" is defined as within 3 months,"long term" is defined as more than 1 year.The short-term and long-term effects are judged by whether the spasm completely disappears.Efficacy evaluation can be divided into "effective" and "partial remission or ineffectiveness"(detailed in the text).Revman 5.3 software was used for meta-analysis.Results:A total of 879 related literatures were searched,and 11 papers meeting the requirements were included in meta-analysis,all of which were English papers included in SCI.The NOS scores of literatures were 8 points for 1 article,7 points for 5 articles and 6 points for 5 articles.were 8 for one,7 for five and 6 for five.Eleven clinical studies included in the literature included 1859 cases.The results of meta analysis showed that:1.The relationship between intraoperative AMR monitoring results and postoperative short-term efficacy: the short-term efficacy of AMR disappearance group was better than that in AMR non disappearance group,the former was 1.26 times more effective than the latter and the difference was statistically significant(RR 1.26,95% CI 1.16-1.37,P < 0.00001);2.The relationship between intraoperative AMR monitoring results and postoperative long-term efficacy: there was no significant difference between AMR disappearance group and AMR non disappearance group(RR 1.11,95% CI 0.98-1.27,P = 0.11).3.Factors influencing the disappearance of AMR: 1)The age was the related factor influencing the disappearance of AMR,and the average age of patients in the AMR disappearance group was higher than that in the AMR non disappearance group(MD = 2.22,95% CI)0.37-4.07,P = 0.02);2)The gender was not the related factor influencing the disappearance of AMR(OR = 0.97,95% CI 0.73-1.28,P = 0.81);3)The diseased side was not the related factor influencing the disappearance of AMR(OR = 0.94,95% CI 0.73-1.21,P = 0.65);4)The course of disease is not related factor influencing the disappearance of AMR(MD =-0.64,95% ci-1.53-0.25,P = 0.16);5)whether botulinum toxin has been used before operation is not related to the disappearance of AMR(OR = 0.86,95% CI 0.44-1.68,P = 0.66);6)The source and number of responsible vessels were not related to the disappearance of AMR(including vertebral artery: OR = 1.2,95% CI 0.79-1.82,P = 0.39;including multiple vessels: OR=0.75,95% CI 0.52-1.08,P = 0.12).Conclusion: For patients with primary HFS treated with MVD,the disappearance of AMR during operation indicates a good short-term outcome,while the prediction of long-term effect is relatively low.Age is the related factor of AMR disappearance.Gender,disease side,course of disease,history of botulinum toxin use,source and number of responsible blood vessel are not the related factors of AMR disappearance. |
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