听神经瘤量化ANS分级及其临床意义  

Signification of Acoustic Neuroma by ANS Classification

作　　者：王飞[1] 梁崇乾 张贺[1] 刘冰[1] 管清亮 杨廷舰[1] 宋浩青[1] 刘伟[1] 

机构地区：[1]潍坊医学院附属医院神经外科,山东潍坊261031 [2]昌乐县人民医院 [3]诸城市中医医院

出　　处：《潍坊医学院学报》2011年第1期13-15,共3页Acta Academiae Medicinae Weifang

摘　　要：目的 探求听神经瘤手术的科学、实用的分级方法,量化手术难易程度并对预后作出较为准确的估计,为临床治疗提供帮助.方法 选取142例经手术治疗的听神经瘤患者,术前均行MRI及CT影像学检查.据影像学肿瘤的大小、与中线的距离、颅神经受累的条数、与脑干的关系、与基底动脉的关系5个方面进行记分,根据总分进行ANS手术分级;将分值大小与手术切除率及术后并发症进行统计学分析.结果 A,B级肿瘤均行肿瘤全切;C级全切53例,全切率84.1%;D级全切37例,全切率67.3%.A,B级于C级、D级呈显著差异（P〈0.05）.术后出现新发颅神经损伤（不包括听神经）、肢体功能受限、共济失调及面神经功能（术后10d左右）较术前加重等并发症,A级0例;B级7例（31.8%）;C级36例（57.1%）,D级42例（75.0%）.结论 ①随着ANS分级增高,手术全切率明显下降（P〈0.05）.②随着ANS分级增高,出现新发颅神经损伤（不包括面听）、肢体功能受限、共济失调及面神经功能较术前加重等术后并发症明显增多（P〈0.05）.Objective To explore a scientific： and practical grading method of acoustic neuroma surgery to quantify the difficulty of operatiou and make more accurate estimates of the prognosis,expectting to offer some help of clinical treatment. Methods One hundred and forly-two acoustic neuroma patients were selected by the surgical treatment,all patients have perfonrmed preoperatively MRI and CT imaging. Five factors were selected：the tumor size of preoperative imaging,the middle distance,the numbers of impaired cranial uerves,the rela- tionship between tumor and brain stern,and the relationship of basilar artery, according the outcomes to proceed ANS surgery classification. Analyze Ihe score and surgical resection rates amt postoperative complications. Results The tumors were performed total resection in A, B grade ;53 cases were ped＇orrned total resection, in C grade, total removal rate is 84.1% ;37 cases in D grade,total removal rate is 67.3%. The difference between A, B grade and C class, D class were significantly （ P 〈 0.05 ）. New cranial nerve injury （ not include auditory nerve）, physical dysfunctiou,ataxia and facial nerve functional deterioration and other complications appear comparing with the preoperative,A grade 0 cases ; B grade 7 cases （ 31. 8 % ） ; C grade 36 cases （ 57.1% ） , D grade 42 （ 75.0% ）. Conclusions ①As the ANS grade increased, the rate of total resection decreased with statistical significances. ②As the ANS grade increased,the rate of new cranial nerve injury. ,physical dysfunction,ataxia and facial nerve functional deterioration and other complications after operation increased with statistically significant meaning.

关 键 词：听神经瘤 手术分级 ANS计分 术后评价 

分 类 号：R739.4[医药卫生—肿瘤]