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大型听神经瘤术中面神经电生理监测的意义

发布时间:2018-06-09 01:27

  本文选题:大型听神经瘤 + 面神经电生理监测 ; 参考:《郑州大学》2014年硕士论文


【摘要】:目的 探讨大型听神经瘤手术中面神经电生理监测对面神经保护的意义。 资料与方法 严格筛选2010年3月~2013年7月在郑州大学第一附属医院手术治疗的67例大型听神经瘤患者,筛选标准:①临床资料完整。②肿瘤均为单侧非复发性。③无r刀或放射性治疗病史。④手术由同一神经外科医师主刀,,患者术前、术后1周面神经功能由同一神经外科医师按House-Brackmann面神经功能分级标准评估。⑤切除肿瘤均选择枕下乙状窦后入路。⑥病理证实为听神经瘤。其中男32例、女35例,年龄30~67(45.7±11.5)岁。右侧29例,左侧38例,术中应用面神经电生理监测设为监测组,未应用设为非监测组。其中监测组31例,男性13例,女性18例,平均年龄(44.9±11.2)岁。非监测组36例,男性14例,女性22例,平均年龄(45.8±11.7)岁。用以比较手术前与手术后各组大型听神经瘤切除率,比较面神经解剖及功能保留率。两组患者的年龄、性别、肿瘤大小及肿瘤性质差异无统计学意义(P0.05)。 结果 1、肿瘤全部切除比例:监测组病例中肿瘤全切除率为82.3%;非监测组中肿瘤全切除率为79.4%,两组差异无统计学意义(P0.05)。 2、面神经解剖保留结果:监测组病例中面神经解剖保留率为90.3%;非监测组病例中面神经解剖保留率为69.4%。监测组结果明显高于非监测组,两组差异有统计学意义(P<0.05)。 3、术后1周面神经功能保留结果:监测组病例中面神经功能保留率为77.4%;非监测组病例中面神经功能保留率为52.7%。监测组明显高于非监测组,两组差异有统计学意义(P<0.05)。 结论 大型听神经瘤术中行面神经电生理监测可以提高面神经解剖和功能保留率,提高手术治疗效果。
[Abstract]:Objective to investigate the significance of facial electrophysiological monitoring in the operation of large acoustic neuroma. Data and methods 67 patients with large acoustic neuroma treated in the first affiliated Hospital of Zhengzhou University from March 2010 to July 2013 were selected strictly. Screening criteria: 1: 1 complete clinical data .2 tumors were unilateral non-recurrent 3 without r knife or radiation therapy history of 4. 4 surgery performed by the same neurosurgeon, patients before operation, 1 week after operation, the facial nerve function was evaluated by the same neurosurgeon according to House-Brackmann 's functional grading standard. 5. All tumors were treated with suboccipital retrosigmoid sinus approach. 6. 6 pathologically proved acoustic neuroma. Of them, 32 were male and 35 were female. The age was 45.7 卤11.5 years old. There were 29 cases on the right side and 38 cases on the left side. The electrophysiological monitoring of facial nerve was used as the monitoring group, but not as the non-monitoring group. There were 31 cases in the monitoring group, 13 males and 18 females, with an average age of 44.9 卤11.2 years. In the non-monitoring group, 36 cases were male (14 cases) and female (22 cases) with an average age of 45.8 卤11.7 years. To compare the resection rate of large acoustic neuroma before and after operation and the anatomic and functional retention rate of facial nerve. The age and sex of the two groups, Results 1. The total resection rate of tumor was 82.3% in the monitoring group, and 79.4% in the non-monitoring group. There was no significant difference between the two groups (P 0.05%, P 0.05%, P 0.05%, P 0.05%, P 0.05%, P 0.05%, P 0.05%, P 0.05%, P < 0.05), and the total tumor resection rate was 79.4% in the non-monitoring group (P < 0.05). The anatomical retention rate of facial nerve was 90.3 in the monitoring group and 69.4 in the non-monitoring group. The results of the monitoring group were significantly higher than that of the non-monitoring group (P < 0.05). The results of facial nerve function preservation at 1 week after operation were as follows: the facial nerve function retention rate was 77.4 in the monitoring group and 52.7 in the non-monitoring group. The difference between the two groups was statistically significant (P < 0.05). Conclusion the electrophysiological monitoring of facial nerve in large acoustic neuroma can improve the anatomic and functional retention rate of facial nerve and the effect of surgical treatment.
【学位授予单位】:郑州大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R739.4

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