【摘要】：目的：對(duì)比分析大型囊性及實(shí)性聽(tīng)神經(jīng)瘤的臨床特點(diǎn),進(jìn)一步探討兩種類(lèi)型聽(tīng)神經(jīng)瘤的手術(shù)治療效果及術(shù)后并發(fā)癥的差別,提高對(duì)兩種類(lèi)型聽(tīng)神經(jīng)瘤的認(rèn)識(shí)。方法：本文采用回顧性分析的統(tǒng)計(jì)方法對(duì)2012年1月-2013年12月齊魯醫(yī)院神經(jīng)外科,收治74例腫瘤直徑≥3cm的聽(tīng)神經(jīng)瘤患者的臨床病例資料進(jìn)行分析。根據(jù)術(shù)中腫瘤性質(zhì),將病例資料分為囊性(n=25)及實(shí)性(n=49)兩組。兩組患者均在面神經(jīng)監(jiān)測(cè)下通過(guò)乙狀竇后入路行手術(shù)治療。對(duì)兩組患者臨床表現(xiàn),術(shù)中腫瘤切除率,面神經(jīng)保留率,術(shù)后短期面神經(jīng)功能,并發(fā)癥發(fā)生率,平均住院天數(shù)進(jìn)行比較分析。 結(jié)果：大型囊性聽(tīng)神經(jīng)瘤首發(fā)癥狀及術(shù)前癥狀中出現(xiàn)小腦功能障礙癥狀的發(fā)生率較實(shí)性聽(tīng)神經(jīng)瘤高。囊性大型聽(tīng)神經(jīng)瘤25例(33.8%),平均最大徑4.7±1.1cm,其中腫瘤全切除17例(68%),次全切除8例(32%),面神經(jīng)解剖保留21例(84%),死亡2例。實(shí)性大型聽(tīng)神經(jīng)瘤49例(66.2%),平均最大徑4.07±±0.91cm,其中腫瘤全切除43例(87.8%),次全切除5例(10.2%),大部切除1例(2%),面神經(jīng)解剖保留48例(98%),無(wú)死亡病例。術(shù)后3天按照House-Brackmann分級(jí)量表進(jìn)行面神經(jīng)功能評(píng)估,大型囊性聽(tīng)神經(jīng)瘤,Ⅰ級(jí)為8例,Ⅱ級(jí)5例,Ⅲ級(jí)5例,Ⅳ級(jí)4例,V級(jí)1例,Ⅵ級(jí)2例,大型實(shí)性聽(tīng)神經(jīng)瘤,Ⅰ級(jí)為16例,Ⅱ級(jí)14例,Ⅲ級(jí)7例,Ⅳ級(jí)6例,Ⅴ級(jí)5例,Ⅵ級(jí)1例。大型囊性聽(tīng)神經(jīng)瘤術(shù)后并發(fā)癥5例,大型實(shí)性聽(tīng)神經(jīng)瘤12例。大型囊性聽(tīng)神經(jīng)瘤住院天數(shù)20.44±7.80天,大型實(shí)性聽(tīng)神經(jīng)瘤住院天數(shù)22.2±±6.1天。 結(jié)論： 1.大型聽(tīng)神經(jīng)瘤的臨床表現(xiàn)以面、聽(tīng)神經(jīng)損害及小腦功能障礙為主,而囊性聽(tīng)神經(jīng)瘤術(shù)前癥狀不典型且多伴有小腦功能障礙。 2.顯微外科手術(shù)是治療大型聽(tīng)神經(jīng)瘤的有效方法,且具有較高的面神經(jīng)功能保留 3.大型囊性聽(tīng)神經(jīng)瘤術(shù)中面神經(jīng)保留率、腫瘤全切率較實(shí)性聽(tīng)神經(jīng)瘤低,應(yīng)做到早期診斷早期治療。 4.大型囊性和實(shí)性聽(tīng)神經(jīng)瘤術(shù)后并發(fā)癥發(fā)生率及住院天數(shù)無(wú)明顯區(qū)別。
[Abstract]:Objective: to compare and analyze the clinical features of large cystic and solid acoustic neuroma, and to explore the difference of surgical treatment and postoperative complications between the two types of acoustic neuroma, and to improve the understanding of the two types of acoustic neuroma. Methods: the clinical data of 74 patients with acoustic neuroma whose tumor diameter 鈮，

本文編號(hào)：2365255