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目的:比较显微血管减压术(MVD)治疗面肌痉挛(HFS)术中异常肌反应(AMR)稳定消失和AMR复现患者的疗效，探讨术中关闭硬脑膜后本已消失的AMR再次出现时的处理策略。方法:选择国家卫健委中日友好医院神经外科自2014年1月至2019年1月行MVD治疗且术中全程监测、手术结束时复查AMR的1705例HFS患者，根据患者术中AMR的监测结果，将患者分为AMR稳定消失组和AMR复现组。全部患者随访12~68个月，比较2组患者延迟治愈率和总治愈率的差异。结果:AMR稳定消失组(1158例)患者中术后即刻治愈1086例，术后0.2~3个月治愈48例，无效24例。AMR复现组(547例)患者中术后即刻治愈301例，术后0.5~6个月治愈232例，无效14例。2组患者的总治愈率(97.9% n vs. 97.4%)差异无统计学意义(n P>0.05)，但AMR复现组患者的延迟治愈率明显高于AMR稳定消失组(42.4%n vs. 4.1%)，差异有统计学意义(n P0.05), but the delayed cure rate in patients from AMR recurrence group was significantly higher than that from AMR stable disappearance group (42.4%n vs. 4.1%, n P<0.05). Re-examination of AMR at the end of surgery showed that AMR disappeared again in 294 patients from the AMR recurrence group without intracranial intervention, and AMR continued to exist in 253 patients at the end of surgery.n Conclusion:After complete intraoperative decompression of HFS by MVD, the AMR recurrence does not require immediate re-operative exploration and decompression, which can still ensure excellent curative effect and has a relatively high probability of delayed cure; and the evaluation of its curative effect should be extended to at least one year after surgery.