眶上外侧入路与单侧额下入路显微切除嗅沟脑膜瘤的临床效果比较

发布时间：2018-01-03 20:28

本文关键词：眶上外侧入路与单侧额下入路显微切除嗅沟脑膜瘤的临床效果比较　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的单侧额下入路是嗅沟脑膜瘤显微切除常用的手术入路,眶上外侧入路具有便捷、美观、微创的优势,近年来也逐渐被应用于嗅沟脑膜瘤显微切除。本文旨在从安全性、有效性等方面对两种手术方式进行比较分析。方法回顾性收集2013年6月1日至2017年1月1日在浙江大学医学院附属第二医院神经外科行嗅沟脑膜瘤手术的65例患者资料,根据手术方法归为眶上外侧入路组(A组,n = 22)和单侧额下入路组(B组,n = 23),随访至2017年3月1日,收集两组患者的基本资料、手术时间、术中出血量、手术切除程度、住院时间、术后并发症、随访结果等信息,从手术安全性、有效性等方面进行比较。结果A组与B组患者在手术时间、手术切除程度、术后嗅功能视功能改变、出院GOS评分、随访终点GOS评分、随访终点KPS评分、复发率、死亡率方面无显著性差异。A组患者需手术干预的并发症率小于B组(0.0%vs4.3%,P0.05),但亦无统计学差异。两组的术中出血量(179.55±89.52mlvs267.39± 147.41ml,P0.05)、住院时间(14.14 ± 3.54 天 vs 18.52 ±5.27 天,P0.05)上的差异显著。结论眶上外侧入路相比于单侧额下入路在能够安全全切嗅沟脑膜瘤的同时具有术中出血量少、住院时间短、严重并发症少等优势,值得进一步推广。
[Abstract]:Objective unilateral subfrontal approach is a common surgical approach for the microresection of olfactory sulcus meningiomas. The supraorbital approach is convenient, beautiful and minimally invasive. In recent years, it has been gradually used in the microexcision of olfactory sulcus meningiomas. Methods from June 1st 2013 to January 1st 2017, olfactory sulcus meningiomas were collected retrospectively from June 1st 2013 to January 1st 2017 in the second affiliated Hospital of Zhejiang University School of Medicine. Data of 65 patients undergoing surgery. According to the operative method, group A (n = 22) and group B (group B) were divided into two groups: supra-lateral orbital approach group (n = 22) and subfrontal approach group B group (n = 23), followed up until March 1st 2017. To collect the basic information, operative time, intraoperative bleeding volume, surgical resection degree, hospitalization time, postoperative complications, follow-up results and other information from the safety of the operation. Results in group A and group B, the operative time, the degree of resection, the changes of olfactory function after operation, the GOS score of discharge, and the GOS score at the end of follow-up were compared. There was no significant difference in KPS score, recurrence rate and mortality. The complication rate in group A was lower than that in group B (P 0.05). However, there was no statistical difference between the two groups. The intraoperative bleeding volume was 179.55 卤89.52 ml vs 267.39 卤147.41 ml P0.05). The hospital stay was 14.14 卤3.54 days vs 18.52 卤5.27 days. Conclusion compared with the unilateral subfrontal approach, the supraorbital approach has the advantages of less intraoperative bleeding, shorter hospital stay and less severe complications. It is worth further popularizing.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.45

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