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

【摘要】：背景和目的:聽神經(jīng)瘤術后患者在面神經(jīng)解剖保留的情況下也常常會出現(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)瘤術后面神經(jīng)功能性損傷的相關因素,從而為術中保護面神經(jīng)功能、改善患者預后提供一定的理論依據(jù)。方法:回顧性分析浙江大學醫(yī)學院附屬第二醫(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,術后6月采用House-Brackmann面神經(jīng)功能分級對患者面神經(jīng)功能進行分級。分別對患者性別、年齡、腫瘤大小、術中面神經(jīng)監(jiān)測情況、腫瘤切除率及手術時長進行單因素分析,再對其中有統(tǒng)計學意義的因素進行Logistic回歸分析。結果: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;術中行面神經(jīng)監(jiān)測的有53例,未行的有20例;腫瘤全切51例,部分切除22例;手術時長4小時的有42例,≥4小時的有31例。術后6月面神經(jīng)功能較好者(Ⅰ-Ⅲ級)52例,占71.2%,功能較差者(Ⅳ-Ⅵ級)21例,占28.8%。單因素分析顯示聽神經(jīng)瘤術后患者面神經(jīng)功能與腫瘤大小(χ2 = 11.427,P = 0.001)、是否行面神經(jīng)監(jiān)測(χ2 = 6.061,P = 0.014)、腫瘤切除率(χ2 = 6.928,P = 0.008)以及手術時間(χ2 = 4.560,P = 0.033)有關。多因素Logistic回歸結果顯示腫瘤大小(P = 0.043)和是否行面神經(jīng)監(jiān)測(P =0.030)是影響術后面神經(jīng)功能的獨立相關因素。結論:腫瘤大小及術中是否行面神經(jīng)功能監(jiān)測是影響術后面神經(jīng)功能的獨立相關因素。腫瘤越大,手術切除后面神經(jīng)功能損傷也越大,而術中面神經(jīng)監(jiān)測可以對面神經(jīng)功能起到保護作用。
[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：1601311