本文選題：聽神經(jīng)瘤　切入點(diǎn)：面神經(jīng)功能　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：背景和目的:聽神經(jīng)瘤術(shù)后患者在面神經(jīng)解剖保留的情況下也常常會(huì)出現(xiàn)周圍性面癱等面神經(jīng)損傷癥狀,本研究旨在探究聽神經(jīng)瘤術(shù)后面神經(jīng)功能性損傷的相關(guān)因素,從而為術(shù)中保護(hù)面神經(jīng)功能、改善患者預(yù)后提供一定的理論依據(jù)。方法:回顧性分析浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院神經(jīng)外科在2014年1月1日至2014年12月31日期間收治并符合研究條件的73例聽神經(jīng)瘤患者的臨床資料,術(shù)后6月采用House-Brackmann面神經(jīng)功能分級(jí)對(duì)患者面神經(jīng)功能進(jìn)行分級(jí)。分別對(duì)患者性別、年齡、腫瘤大小、術(shù)中面神經(jīng)監(jiān)測(cè)情況、腫瘤切除率及手術(shù)時(shí)長(zhǎng)進(jìn)行單因素分析,再對(duì)其中有統(tǒng)計(jì)學(xué)意義的因素進(jìn)行Logistic回歸分析。結(jié)果:本文共納入73例患者,男性27例,女性46例,男女比1:1.7;年齡最小24歲,最大76歲,平均年齡50歲;腫瘤最大直徑為1.2-6.3cm,平均3.1cm,腫瘤直徑≤3cm的有40例,3cm的有33例;術(shù)中行面神經(jīng)監(jiān)測(cè)的有53例,未行的有20例;腫瘤全切51例,部分切除22例;手術(shù)時(shí)長(zhǎng)4小時(shí)的有42例,≥4小時(shí)的有31例。術(shù)后6月面神經(jīng)功能較好者(Ⅰ-Ⅲ級(jí))52例,占71.2%,功能較差者(Ⅳ-Ⅵ級(jí))21例,占28.8%。單因素分析顯示聽神經(jīng)瘤術(shù)后患者面神經(jīng)功能與腫瘤大小(χ2 = 11.427,P = 0.001)、是否行面神經(jīng)監(jiān)測(cè)(χ2 = 6.061,P = 0.014)、腫瘤切除率(χ2 = 6.928,P = 0.008)以及手術(shù)時(shí)間(χ2 = 4.560,P = 0.033)有關(guān)。多因素Logistic回歸結(jié)果顯示腫瘤大小(P = 0.043)和是否行面神經(jīng)監(jiān)測(cè)(P =0.030)是影響術(shù)后面神經(jīng)功能的獨(dú)立相關(guān)因素。結(jié)論:腫瘤大小及術(shù)中是否行面神經(jīng)功能監(jiān)測(cè)是影響術(shù)后面神經(jīng)功能的獨(dú)立相關(guān)因素。腫瘤越大,手術(shù)切除后面神經(jīng)功能損傷也越大,而術(shù)中面神經(jīng)監(jiān)測(cè)可以對(duì)面神經(jīng)功能起到保護(hù)作用。
[Abstract]:Background and objective: facial nerve injury symptoms such as peripheral facial paralysis often occur in patients with facial nerve preservation after acoustic neuroma surgery. The purpose of this study was to explore the related factors of facial nerve functional injury after acoustic neuroma surgery. In order to protect facial nerve function during operation, Methods: a retrospective analysis of 73 cases of hearing in the second affiliated Hospital of Zhejiang University Medical College from January 1st 2014 to December 31st 2014 was conducted. Clinical data of patients with neuroma, In June, the facial nerve function of the patients was graded by House-Brackmann 's facial nerve function grading. The patients' sex, age, tumor size, intraoperative facial nerve monitoring, tumor resection rate and length of operation were analyzed by single factor analysis. Results: there were 73 patients, male 27, female 46, the ratio of male to female was 1: 1.7, the age was 24 years old, the maximum was 76 years old, the average age was 50 years old. The maximum diameter of the tumor was 1.2-6.3 cm (mean 3.1 cm). There were 33 cases with tumor diameter 鈮，

本文編號(hào)：1601311