神经电生理监测、术中B超应用下听神经瘤的显微手术配合  

The Operative Cooperation in Microsurgery of Acoustic Neurinoma with Nerve Electrophysiology Monitoring and Intraoperative B-ultrasonography

作　　者：赖宇芬[1] 陈信芝[1] 刘光娥[1] 

机构地区：[1]中山大学附属第三医院手术麻醉中心,广东广州510630

出　　处：《临床医学工程》2011年第9期1422-1423,共2页Clinical Medicine & Engineering

摘　　要：目的探讨显微手术切除听神经瘤中应用神经电生理监测、术中B超的手术配合要点及意义。方法回顾研究我院近5年来显微手术治疗听神经瘤患者40例,其中28患者在术中行神经电生理监测以及应用术中B超检查(监测组);其余12例为非监测组。手术中熟练有效的护理配合保障手术的顺利进行。结果 40例患者跟踪随访3个月～4年,未监测组肿瘤全切8例,4例患者行肿瘤近全切;神经电生理监测+B超组(下简称监测组)肿瘤全切26例,2例患者行肿瘤近全切。未监测组7例术后患者面瘫恢复或好转,4例无明显变化,加重1例;听力恢复或好转1例,10例无变化,加重1例。监测组术后患者面瘫恢复或好转24例,1例无明显变化,加重3例;听力恢复或好转12例,16例无明显变化,加重0例。监测组与非监测组在肿瘤切除率、面/听神经功能改善方面比较,P均<0.05。结论听神经瘤显微手术治疗中,充分的术前准备,协调的护理配合,加上神经电生理监测、B超应用可较好地保护面、听神经的功能,提高全切率,对保障手术的顺利进行,提高手术效果有积极的意义。Objective To investigate the key points and significance of the operative cooperation in microsurgery of acoustic neurinoma with nerve electrophysiology monitoring and intraoperative B-ultrasonography.Methods To study retrospectively 40 patients who received microsurgery of acoustic neurinoma in 5 years,including 28 patients（monitoring group） and other 12 patients（non-monitoring group）.Results 40 patients were followed up for 3 months to 4 years.In non-monitoring group 8 patients received total tumor removal and 4 patients received near total tumor removal;in monitoring group 26 patients received total tumor removal and 2 patients received near total tumor removal.In non-monitoring group after operation 7 patients got recovery or improvement of facial paralysis,4 patients had no significant changes,one patient got deterioration;one patient got recovery or improvement of hearing,10 patients had no significant changes,one patient got deterioration;in monitoring group after operation 24 patients got recovery or improvement of facial paralysis,one patient had no significant changes,3 patients got deterioration;12 patients got recovery or improvement of hearing,16 patients had no significant changes,no patient got deterioration.In monitoring group and the non-monitoring group by comparison of the tumor resection rate,facial/auditory nerve function improvement,P 0.05.Conclusion In microsurgery of acoustic neurinoma,it is very important to provide sufficient preoperative preparation,perfect operative cooperation as well as nerve electrophysiology monitoring and intraoperative B-ultrasonography.With these action,we can protect facial and auditory nerve function better and improve the rate of tumor resection.

关 键 词：听神经瘤 神经电生理监测 手术配合 术中B超 护理 

分 类 号：R472.3[医药卫生—护理学]