面神經(jīng)炎診治新進(jìn)展課件

面神經(jīng)炎的診治何海蘭Evaluauononr.chAsposeslidesforNET4odientPalvetonoCreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL面神經(jīng)炎的診治1定義)面神經(jīng)炎又稱(chēng)貝爾麻痹(Bell'spalsy是由于面神經(jīng)急性非化膿性炎癥所致的周?chē)悦嫔窠?jīng)麻痹Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL定義2按上癱與核下癱鑒別大腦皮質(zhì)運(yùn)動(dòng)區(qū)—一皮質(zhì)延髓束—面神經(jīng)核面神經(jīng)—面部各肌雙側(cè)皮質(zhì)延髓束支配面上部各肌(額肌、皺眉肌、側(cè)皮質(zhì)延髓束支配面下部各肌(頰肌、口輪匝中樞性面癱是病灶對(duì)側(cè)下面部癱瘓(鼻唇溝變淺口角下垂);周?chē)悦姘c表現(xiàn)患側(cè)上下面部癱瘓Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL按上癱與核下癱鑒別3面神經(jīng)通路面神經(jīng)從橋腦尾端面神經(jīng)核發(fā)出纖維先繞過(guò)展神經(jīng)核,向前下行于聽(tīng)神經(jīng)處穿出。再穿過(guò)蛛網(wǎng)膜下腔,在聽(tīng)神經(jīng)上方進(jìn)入內(nèi)耳孔。以后經(jīng)丙聽(tīng)道及巖骨中狹長(zhǎng)的骨性管腔(面神經(jīng)管)下行,橫過(guò)膝狀神經(jīng)節(jié),最后由莖乳孔出顱腔分布至面部表情肌Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL面神經(jīng)通路4病因未完全闡明無(wú)論是缺血或炎癥所引起的局部面神經(jīng)組織水腫,都會(huì)促使神經(jīng)功發(fā)生障礙而出現(xiàn)面癱。Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL病因5局部營(yíng)養(yǎng)神經(jīng)的血管因受風(fēng)寒發(fā)生痙攣,致該神經(jīng)組織缺血、水腫、受壓而致病癘毒感染所致的面神經(jīng)炎或風(fēng)濕性面神經(jīng)炎都會(huì)產(chǎn)生面神經(jīng)腫脹、受壓、血液循環(huán)障礙而致面神經(jīng)麻痹Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL局部營(yíng)養(yǎng)神經(jīng)的血管因受風(fēng)寒發(fā)生痙攣,6病原近年研宄發(fā)現(xiàn)面神經(jīng)炎主要由病毒感染所致。其絕大部分是由型單純皰疹病毒(Hs∨1)所致,此外,EB病毒、腮腺炎病毒、風(fēng)疹病毒也和面神經(jīng)炎的發(fā)病有關(guān)。Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL病原7病理變化主要為面神經(jīng)水胂,髓鞘或軸突有不同程度的變性,以在莖乳孔和面神經(jīng)管內(nèi)的部分尤為顯著Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL病理變化8臨床表現(xiàn)面神經(jīng)炎常為急性起病9任何年齡均可發(fā)病但以20-40歲最多見(jiàn)o男性多于女性Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL臨床表現(xiàn)9癥狀可手?jǐn)?shù)小時(shí)或1-2天內(nèi)達(dá)高峰表現(xiàn)為一側(cè)面部表情肌的完全性癡如額紋消失,眼裂變大,閉目不緊患側(cè)鼻唇溝變淺,口角下垂,露齒口角偏向?qū)?cè),鼓腮漏氣,咀嚼無(wú)力Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL癥狀可手?jǐn)?shù)小時(shí)或1-2天內(nèi)達(dá)高峰10面神經(jīng)炎診治新進(jìn)展課件11面神經(jīng)炎診治新進(jìn)展課件12面神經(jīng)炎診治新進(jìn)展課件13面神經(jīng)炎診治新進(jìn)展課件14面神經(jīng)炎診治新進(jìn)