發(fā)布時間：2018-06-09 01:27

  本文選題：大型聽神經(jīng)瘤 + 面神經(jīng)電生理監(jiān)測��； 參考：《鄭州大學(xué)》2014年碩士論文

【摘要】：目的 探討大型聽神經(jīng)瘤手術(shù)中面神經(jīng)電生理監(jiān)測對面神經(jīng)保護的意義。 資料與方法 嚴(yán)格篩選2010年3月～2013年7月在鄭州大學(xué)第一附屬醫(yī)院手術(shù)治療的67例大型聽神經(jīng)瘤患者,篩選標(biāo)準(zhǔn)：①臨床資料完整。②腫瘤均為單側(cè)非復(fù)發(fā)性。③無r刀或放射性治療病史。④手術(shù)由同一神經(jīng)外科醫(yī)師主刀，，患者術(shù)前、術(shù)后1周面神經(jīng)功能由同一神經(jīng)外科醫(yī)師按House-Brackmann面神經(jīng)功能分級標(biāo)準(zhǔn)評估。⑤切除腫瘤均選擇枕下乙狀竇后入路。⑥病理證實為聽神經(jīng)瘤。其中男32例、女35例，年齡30～67(45.7±11.5)歲。右側(cè)29例，左側(cè)38例,術(shù)中應(yīng)用面神經(jīng)電生理監(jiān)測設(shè)為監(jiān)測組，未應(yīng)用設(shè)為非監(jiān)測組。其中監(jiān)測組31例，男性13例，女性18例，平均年齡(44.9±11.2)歲。非監(jiān)測組36例，男性14例，女性22例，平均年齡(45.8±11.7)歲。用以比較手術(shù)前與手術(shù)后各組大型聽神經(jīng)瘤切除率，比較面神經(jīng)解剖及功能保留率。兩組患者的年齡、性別、腫瘤大小及腫瘤性質(zhì)差異無統(tǒng)計學(xué)意義(P0.05)。 結(jié)果 1、腫瘤全部切除比例：監(jiān)測組病例中腫瘤全切除率為82.3%；非監(jiān)測組中腫瘤全切除率為79.4%，兩組差異無統(tǒng)計學(xué)意義(P0.05)。 2、面神經(jīng)解剖保留結(jié)果：監(jiān)測組病例中面神經(jīng)解剖保留率為90.3%；非監(jiān)測組病例中面神經(jīng)解剖保留率為69.4%。監(jiān)測組結(jié)果明顯高于非監(jiān)測組，兩組差異有統(tǒng)計學(xué)意義(P＜0.05)。 3、術(shù)后1周面神經(jīng)功能保留結(jié)果：監(jiān)測組病例中面神經(jīng)功能保留率為77.4%；非監(jiān)測組病例中面神經(jīng)功能保留率為52.7%。監(jiān)測組明顯高于非監(jiān)測組，兩組差異有統(tǒng)計學(xué)意義(P＜0.05)。 結(jié)論 大型聽神經(jīng)瘤術(shù)中行面神經(jīng)電生理監(jiān)測可以提高面神經(jīng)解剖和功能保留率，提高手術(shù)治療效果。
[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 鹵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 鹵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 鹵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.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R739.4

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本文編號：1998169