發(fā)布時間：2018-05-29 05:55

  本文選題：聽神經(jīng)瘤 + 內(nèi)聽道��； 參考：《山西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:研究在聽神經(jīng)瘤顯微手術(shù)中,磨除內(nèi)聽道與手術(shù)療效的相關(guān)性,并分析其對面神經(jīng)的保護(hù)和手術(shù)療效的意義。方法:針對山西醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科的兩組(術(shù)中磨除內(nèi)聽道組與未磨除內(nèi)聽道組)顯微手術(shù)治療聽神經(jīng)瘤患者的臨床資料進(jìn)行回顧性分析研究(未磨除組26例:2007年10月-2010年9月期間;磨除組27例:2010年10月-2013年9月期間),運(yùn)用SPSS 13.0統(tǒng)計軟件分析兩組(磨除內(nèi)聽道組與未磨除內(nèi)聽道組)術(shù)式與聽神經(jīng)瘤手術(shù)療效(包括腫瘤全切除率及術(shù)后即刻3天內(nèi)、7天、6個月、1年的面神經(jīng)功能狀態(tài))的相關(guān)性,并分析其對面神經(jīng)功能保護(hù)和手術(shù)療效的意義。結(jié)果:未磨除內(nèi)聽道組(26例):腫瘤全切16例(61.5%),次全切5例(19.2%),大部切除5例(19.2%);術(shù)后面神經(jīng)功能H-B分級良好率(Ⅰ/Ⅱ級):即刻(1-3天)良好率占84.61%,7天良好率占30.76%,6個月良好率占42.31%,1年良好率占57.69%。磨除內(nèi)聽道組(27例):腫瘤全切24例(88.9%),次全切2例(7.4%),大部切除1例(3.7%);術(shù)后面神經(jīng)功能H-B分級良好率(Ⅰ/Ⅱ級):即刻良好率占88.89%,7天良好率占40.74%,6個月良好率占48.15%,1年良好率占85.19%。通過Wilcoxon秩和檢驗,分析磨除內(nèi)聽道與未磨除內(nèi)聽道組中腫瘤的全切除率,P0.05,具有統(tǒng)計學(xué)意義;通過χ2檢驗,術(shù)后遠(yuǎn)期(1年后)面神經(jīng)功能良好率(Ⅰ/Ⅱ級),P0.05,具有統(tǒng)計學(xué)意義。結(jié)論:熟悉內(nèi)聽道的解剖結(jié)構(gòu),并了解內(nèi)聽道內(nèi)面聽神經(jīng)與腫瘤之間的解剖位置關(guān)系,術(shù)中應(yīng)用神經(jīng)電生理監(jiān)測,充分磨開內(nèi)聽道后壁,可提高聽神經(jīng)瘤的全切除率以及面神經(jīng)功能的保護(hù)率,從而可提高術(shù)后患者的生活質(zhì)量,在臨床上具有非常重要的意義。
[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，

本文編號：1949753