听神经瘤显微手术中磨除内听道与手术疗效的相关性研究

发布时间：2018-05-29 05:55

  本文选题：听神经瘤 + 内听道　； 参考：《山西医科大学》2015年硕士论文

【摘要】：目的:研究在听神经瘤显微手术中,磨除内听道与手术疗效的相关性,并分析其对面神经的保护和手术疗效的意义。方法:针对山西医科大学第一附属医院神经外科的两组(术中磨除内听道组与未磨除内听道组)显微手术治疗听神经瘤患者的临床资料进行回顾性分析研究(未磨除组26例:2007年10月-2010年9月期间;磨除组27例:2010年10月-2013年9月期间),运用SPSS 13.0统计软件分析两组(磨除内听道组与未磨除内听道组)术式与听神经瘤手术疗效(包括肿瘤全切除率及术后即刻3天内、7天、6个月、1年的面神经功能状态)的相关性,并分析其对面神经功能保护和手术疗效的意义。结果:未磨除内听道组(26例):肿瘤全切16例(61.5%),次全切5例(19.2%),大部切除5例(19.2%);术后面神经功能H-B分级良好率(Ⅰ/Ⅱ级):即刻(1-3天)良好率占84.61%,7天良好率占30.76%,6个月良好率占42.31%,1年良好率占57.69%。磨除内听道组(27例):肿瘤全切24例(88.9%),次全切2例(7.4%),大部切除1例(3.7%);术后面神经功能H-B分级良好率(Ⅰ/Ⅱ级):即刻良好率占88.89%,7天良好率占40.74%,6个月良好率占48.15%,1年良好率占85.19%。通过Wilcoxon秩和检验,分析磨除内听道与未磨除内听道组中肿瘤的全切除率,P0.05,具有统计学意义;通过χ2检验,术后远期(1年后)面神经功能良好率(Ⅰ/Ⅱ级),P0.05,具有统计学意义。结论:熟悉内听道的解剖结构,并了解内听道内面听神经与肿瘤之间的解剖位置关系,术中应用神经电生理监测,充分磨开内听道后壁,可提高听神经瘤的全切除率以及面神经功能的保护率,从而可提高术后患者的生活质量,在临床上具有非常重要的意义。
[Abstract]:Aim: to study the relationship between the removal of the internal auditory canal and the surgical efficacy in microsurgery of acoustic neuroma, and to analyze its significance in the protection of facial nerve and the effect of operation. Methods: the clinical data of patients with acoustic neuroma treated by microsurgery in the first affiliated Hospital of Shanxi Medical University were analyzed retrospectively. 26 cases in the grinding group: from October 2007 to September 2010; 27 cases in the grinding group: from October 2010 to September 2013, the SPSS 13.0 statistical software was used to analyze the results of operation and acoustic neuroma operation (including total resection rate of tumor and 3 cases immediately after operation) in the two groups (internal auditory canal removal group and non-grinding internal auditory canal group). The correlation between 7 days, 6 months, and 1 year of facial nerve function, The significance of the protection of facial nerve function and the curative effect of operation were analyzed. Results: there were 26 cases of internal auditory canal without grinding: 16 cases had total resection of the tumor (61.5%), 5 cases had subtotal resection (19.2%), 5 cases had partial resection (19.2%), the good rate of H-B grade of facial nerve function (鈪，

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