目的 通过高频超声（HFUS）探讨周围性面瘫（PFP）急性期患者颅外段面神经主干直径、局部血流动力学、面肌厚度的改变。 方法 纳入60例急性PFP患者作为PFP组，另纳入30例健康人群作为对照组。通过HFUS扫查并记录颅外段面神经主干直径（FN-d），面动脉直径（FA-d），面动脉收缩期流速（FA-Vs）、面动脉舒张期流速（FA-Vd）、面动脉阻力指数（FA-RI）、额肌厚度（FM-t）、降口角肌厚度（DAO-t）、降口唇肌厚度（DLI-t）等面部参数。评估各面部参数在PFP急性期诊断中的可行性，并进行组内及组间差异性比较，通过Pearson相关性分析PFP患者急性期面部参数与House-Brackmann（H-B）量表评分的相关性。 结果 （1）PFP组H-B量表评分显著低于对照组，差异有统计学意义（P < 0.05）。（2）不同检测者重复测量面部参数可信度良好（ICC > 0.75）。（3）PFP组患侧FN-d、FA-RI值高于健侧和对照组、FA-Vs、FA-Vd、DAO-t、DLI-t值低于健侧和对照组，差异有统计学意义（P < 0.05）。（4）PFP组患侧FN-d、FA-RI值与H-S量表评分成负相关（r = -0.847，P < 0.05；r = -0.863，P < 0.05）；FA-Vs、FA-Vd、DAO-t、DLI-t与H-S量表评分成正相关（r = 0.808，P < 0.05；r = 0.757，P < 0.05；r = 0.836，P < 0.05；r = 0.694，P < 0.05）。 结论 HFUS可有效检出PFP患者急性期颅外段面神经主干直径的增加、局部微循环障碍以及面肌萎缩等特征性改变，且FN-d、FA-Vs、FA-Vd、FA-RI、DAO-t、DLI-t的增高与减低能够准确反映PFP的改善或进展，对临床病情监测和疗效评估具有重要的指导意义。

Objective To investigate the changes of diameter of the main trunk of the extracranial segment of the facial nerve， local hemodynamics and facial muscle thickness in patients with peripheral facial palsy （PFP） at acute stage by high frequency ultrasound（HFUS）. Methods Sixty patients with acute PFP were enrolled as the PFP group， and 30 healthy people were selected as the control group.The following facial parameters were scanned and recorded using HFUS： diameter of the main trunk of the extracranial segment of the facial nerve （FN-d）， facial artery diameter （FA-d）， facial artery systolic velocity （FA-Vs）， facial artery diastolic velocity （FA-Vd）， facial artery resistance index （FA-RI）， frontalis muscle thickness （FM-t）， depressor anguli oris muscle thickness （DAO-t）， and depressor labii inferioris muscle thickness （DLI-t）.The feasibility of facial parameters in the diagnosis of acute-phase peripheral facial palsy （PFP） was evaluated， with intra-group and inter-group variability comparisons performed. Pearson correlation analysis was conducted to evaluate the relationship between acute-phase facial parameters and House-Brackmann （H-B） scale scores in PFP patients. Results （1）The H-B score of the PFP group was significantly lower than that of the control group， and the difference was statistically significant （P < 0.05）. （2）The reliability of repeated measurements of facial parameters by different testers is good （ICC > 0.75）. （3）The FN-d and FA-RI values on the affected side of PFP group were higher than those on the healthy side and control group， and FA-Vs， FA-Vd， DAO-t and DLI-t values were lower than those on the healthy side and control group， with statistical significance （P < 0.05）. （4）The FN-d and FA-RI values of the affected side in the PFP group were negatively correlated with the H-S scale score （r = -0.847， P < 0.05； r = -0.863， P < 0.05）； FA Vs， FA Vd， DAO-t， DLI-t are positively correlated with H-S scale scores （r = 0.808， P < 0.05； r = 0.757， P < 0.05； r = 0.836， P < 0.05； r = 0.694， P < 0.05）. Conclusions HFUS can effectively detect the characteristic changes such as the increase in the diameter of the extrcranial facial nerve trunk， local microcirculation disturbance and facial muscle atrophy in patients with PFP in the acute stage， and the increase and decrease of FN-d， FA Vs， FA Vd， FA-RI， DAO-t， and DLI-t can accurately reflect the improvement or progress of PFP， which has important guiding significance for clinical disease monitoring and efficacy evaluation.