桥脑小脑角巨大肿瘤术中神经电生理监护的研究  

Neurophysiological monitoring during the resection of great tumors in cerebellopontine angle

作　　者：毛之奇[1] 陆永建[1] 曾白云[1] 朱世强[1] 余敦星[1] 戴文伟[1] 梁建峰[1] 李波[1] 舒江红[1] 李韵辉[1] 

机构地区：[1]广州医学院第二附属医院神经外科,广州510260

出　　处：《中华神经医学杂志》2005年第12期1235-1237,共3页Chinese Journal of Neuromedicine

摘　　要：目的研究在桥脑小脑角肿瘤切除手术中如何进行多方面术中神经电生理监护,以更好地保护神经功能。方法选取2004￣2005年我院桥脑小脑角巨大肿瘤患者57例,采取乙状窦后入路对肿瘤进行切除,并分为传统监护组和综合监护组在术中进行神经电生理监护。术后一周分别从肿瘤切除程度,肢体运动和感觉功能,听觉功能,面肌功能和吞咽功能五个方面对患者进行综合评价,比较传统监护组和综合监护组术前术后功能的变化,采用SPSS11.0统计软件分析不同监护组监护结果的差异。结果与传统监护组相比,综合监护组提高了肿瘤的全切率,减低肢体运动感觉功能缺失,保护了后组颅神经的功能。而在听觉功能、面肌功能和吞咽功能的保护方面两者则无差异。结论对于大型听神经瘤患者,进行多方面综合的术中电生理监护可以更好地保护神经功能,而听觉诱发电位则较少能代表术中情况。Objective To investigate the neurophysiological monitonng m removing great tumors in cerebellopontine angle for protecting nerve functions. Methods Great tumors in cerebellum pontine of 57 cases from 2004 to 2005 were resected via retrosigmoid approach with intraoperative neurophysiological monitoring. All the patients were divided into traditional monitoring group and multiple monitoring group according to different monitoring programs. The patients were evaluated in 5 aspects of tumor resection extent, limb motor and sensory function, auditory function, facial muscle function, and swallowing function 1 week after operation. The differences in the functional changes between traditional monitoring group and multiple monitoring group were analyzed with SPSS 11.0. Results Compared with the traditional group, the patients in multiple monitoring group got a higher total removal rate and a less rate of motor and sensory function lossand, and were protected better against posterior cranial nerve injury. There was no significant difference between the two groups in protecting auditory function, facial muscle function and swallow function. Conclusion To protect nervous functions, the multiple intraoperative monitoring should be taken in the procedure ofresecting great tumors in cerebellopontine angle, however, BAEP plays a less role.

关 键 词：桥脑小脑角肿瘤 术中电生理监护 诱发电位 听觉 脑干 诱发电位 躯体感觉 肌电图 

分 类 号：R739.4[医药卫生—肿瘤]