周围性面瘫患者的面神经功能训练专家共识

doi:10.7518/hxkq.2023.2023200

华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (6): 613-621.doi: 10.7518/hxkq.2023.2023200

• 专家共识 • 下一篇

周围性面瘫患者的面神经功能训练专家共识

陈芸梅¹(), 刘艳², 黄秋雨³, 罗姜⁴, 吴红梅⁵, 王烨华⁶, 吴玲⁷, 李秀娥⁸(), 毕小琴⁹()

^1.中山大学附属第一医院口腔颌面外科，广州 510080
^2.深圳市人民医院口腔医学中心颌面外科，深圳 518020
^3.中山大学附属口腔医院口腔颌面外科，广州 510055
^4.中南大学湘雅口腔医院护理部，长沙 410000
^5.南京医科大学附属口腔医院护理部，南京 210029
^6.郑州大学第一附属医院口腔颌面外科，郑州 450052
^7.武汉大学口腔医院口腔颌面创伤与颞下颌关节外科，武汉 430079
^8.北京大学口腔医院护理部，北京 100081
^9.口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心四川大学华西口腔医院护理部，成都 610041

收稿日期:2023-06-27 修回日期:2023-09-22 出版日期:2023-12-01 发布日期:2023-11-27
通讯作者: 李秀娥,毕小琴 E-mail:chenyunm@mail.sysu.edu.cn;lixiue1216@163.com;hxbxq@163.com
作者简介:陈芸梅，副主任护师，本科，E-mail：chenyunm@mail.sysu.edu.cn
基金资助:
四川省科技计划项目(2022JDKP0007);广东省医学科研基金(A2021008);广东省护理学会团体标准立项(粤护字［2023］3号)

Facial nerve function training in patients with peripheral facial paralysis: an expert consensus

Chen Yunmei¹(), Liu Yan², Huang Qiuyu³, Luo Jiang⁴, Wu Hongmei⁵, Wang Yehua⁶, Wu Ling⁷, Li Xiu’e⁸(), Bi Xiaoqin⁹()

^1.Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
^2.Dept. of Maxillofacial Surgery, Stomatology Center, Shenzhen People’s Hospital, Shenzhen 518020, China
^3.Dept. of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
^4.Dept. of Nursing, Xiangya Stomatological Hospital, Central South University, Changsha 410000, China
^5.Dept. of Nursing, Stomatological College of Nanjing Medical University, Nanjing 210029, China
^6.Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
^7.Dept. of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, Hospital of Stomatology, Wuhan University, Wuhan 430079, China
^8.Dept. of Nursing, Hospital of Stomatology, Peking University, Beijing 100081, China
^9.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2023-06-27 Revised:2023-09-22 Online:2023-12-01 Published:2023-11-27
Contact: Li Xiu’e,Bi Xiaoqin E-mail:chenyunm@mail.sysu.edu.cn;lixiue1216@163.com;hxbxq@163.com
Supported by:
Science and Technology Plan of Sichuan Province(2022JDKP0007);Guangdong Provincial Medical Research Fund Project(A2021008);Guangdong Provincial Nursing Association Group Standard Project Approval (Guangdong Nursing [2023]3). Correspondence: Bi Xiaoqin, E-mail: hxbxq@163.com;Li Xiu’e, E-mail: lixiue1216@163.com

摘要/Abstract

摘要：

周围性面瘫患者进行面神经训练可预防面部表情肌萎缩，促进面瘫康复。目前临床尚缺乏具体、统一的面神经训练技术标准，这造成了临床上训练方法繁多、水平参差不齐的现状。为了规范护理人员面神经功能训练技术的应用，本团队召集国内相关专家，基于循证结合周围性面瘫的疾病特点和专家临床经验，通过深度访谈专家，进行专家函询和专家会议，最终制定了《周围性面瘫患者的面神经功能训练专家共识》，对面神经功能训练时机、训练方法、评价方法、健康教育等方面给出了规范化建议，供临床参考。

关键词: 周围性面瘫, 面神经功能训练, 专家共识

Abstract:

Facial nerve training can prevent facial expression muscle atrophy and promote the recovery of facial para-lysis in patients with peripheral facial paralysis. However, there is still a lack of specific and unified technical standards for facial nerve training, which results in a variety of clinical training methods and uneven levels. In order to standardize the application of facial nerve function training technology for nursing staff, the study convened relevant domestic experts, based on evidence-based combination with the disease characteristics of peripheral facial paralysis and expert clinical experience, conducted in-depth interviews with experts, expert correspondence and expert meetings, and finally formulated the expert consensus on facial nerve function training in patients with peripheral facial paralysis. Overall, suggestions for standardizing the timing, training methods, evaluation methods, health education and other aspects were provided for clinical reference.

Key words: peripheral facial paralysis, training technique of facial nerve function, expert consensus

中图分类号:

R 745.1⁺2

陈芸梅, 刘艳, 黄秋雨, 罗姜, 吴红梅, 王烨华, 吴玲, 李秀娥, 毕小琴. 周围性面瘫患者的面神经功能训练专家共识[J]. 华西口腔医学杂志, 2023, 41(6): 613-621.

Chen Yunmei, Liu Yan, Huang Qiuyu, Luo Jiang, Wu Hongmei, Wang Yehua, Wu Ling, Li Xiu’e, Bi Xiaoqin. Facial nerve function training in patients with peripheral facial paralysis: an expert consensus[J]. West China Journal of Stomatology, 2023, 41(6): 613-621.

图/表 2

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分级	面神经损伤程度
Ⅰ 神经失用	生理性传导阻滞，但轴突与神经元及终末效应器之间仍保持连续性
Ⅱ 轴突中断	轴突断离但神经内膜保持完整
Ⅲ 神经断裂	轴突和神经内膜断离，但神经束膜仍保持完整
Ⅳ 神经束膜断裂	神经外膜内结构已严重损坏，但尚未完全断裂
Ⅴ 神经断离	神经干完全断裂，失去连续性

分级	程度	总体	静止	运动
Ⅰ级	正常	各区面肌运动正常
Ⅱ级	轻度功能异常	仔细检查时有轻度的面肌无力，可有非常轻的联带运动	面部对称，肌张力正常	额部正常，稍用力闭眼完全，口角轻度不对称
Ⅲ级	中度功能异常	明显的面肌无力，但无面部变形，联带运动明显或半面痉挛	面部对称，肌张力正常	额部减弱，用力后闭眼完全，口角最大力轻度不对称
Ⅳ级	中重度功能异常	明显的面肌无力和/或面部变形	面部对称，肌张力正常	额部无，闭眼不完全，口角用最大力后不对称
Ⅴ级	重度功能异常	仅有几乎不能察觉的面部运动	面部不对称	额部无，闭眼不完全，口角轻微运动
Ⅵ级	完全麻痹	无运动

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周围性面瘫患者的面神经功能训练专家共识

Facial nerve function training in patients with peripheral facial paralysis: an expert consensus

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