面神经炎诊治新进展课件

面神经炎的诊治何海兰Evaluauononr.chAsposeslidesforNET4odientPalvetonoCreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL面神经炎的诊治1定义)面神经炎又称贝尔麻痹(Bell'spalsy是由于面神经急性非化脓性炎症所致的周围性面神经麻痹Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL定义2按上瘫与核下瘫鉴别大脑皮质运动区—一皮质延髓束—面神经核面神经—面部各肌双侧皮质延髓束支配面上部各肌(额肌、皱眉肌、侧皮质延髓束支配面下部各肌(颊肌、口轮匝中枢性面瘫是病灶对侧下面部瘫痪(鼻唇沟变浅口角下垂);周围性面瘫表现患侧上下面部瘫痪Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL按上瘫与核下瘫鉴别3面神经通路面神经从桥脑尾端面神经核发出纤维先绕过展神经核,向前下行于听神经处穿出。再穿过蛛网膜下腔,在听神经上方进入内耳孔。以后经丙听道及岩骨中狭长的骨性管腔(面神经管)下行,横过膝状神经节,最后由茎乳孔出颅腔分布至面部表情肌Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL面神经通路4病因未完全阐明无论是缺血或炎症所引起的局部面神经组织水肿,都会促使神经功发生障碍而出现面瘫。Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL病因5局部营养神经的血管因受风寒发生痉挛,致该神经组织缺血、水肿、受压而致病疠毒感染所致的面神经炎或风湿性面神经炎都会产生面神经肿胀、受压、血液循环障碍而致面神经麻痹Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL局部营养神经的血管因受风寒发生痉挛,6病原近年研宄发现面神经炎主要由病毒感染所致。其绝大部分是由型单纯疱疹病毒(Hs∨1)所致,此外,EB病毒、腮腺炎病毒、风疹病毒也和面神经炎的发病有关。Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL病原7病理变化主要为面神经水胂,髓鞘或轴突有不同程度的变性,以在茎乳孔和面神经管内的部分尤为显著Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL病理变化8临床表现面神经炎常为急性起病9任何年龄均可发病但以20-40岁最多见o男性多于女性Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL临床表现9症状可手数小时或1-2天内达高峰表现为一侧面部表情肌的完全性痴如额纹消失,眼裂变大,闭目不紧患侧鼻唇沟变浅,口角下垂,露齿口角偏向对侧,鼓腮漏气,咀嚼无力Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2004-2017AsposePtyL症状可手数小时或1-2天内达高峰10面神经炎诊治新进展课件11面神经炎诊治新进展课件12面神经炎诊治新进展课件13面神经炎诊治新进展课件14面神经炎诊治新进