听神经瘤术后面神经功能预后的影响因素分析  

Analysis of influential factors for prognosis of facial nerve function after surgical resection of acoustic neuroma

作　　者：孟哲 韩松[1] 刘宁[1] 闫长祥[1] 

机构地区：[1]首都医科大学三博脑科医院神经外科,北京100093

出　　处：《中国微侵袭神经外科杂志》2017年第12期529-532,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家课题支撑计划(编号:2014BAI04B01)

摘　　要：目的探讨听神经瘤术后面神经功能预后的影响因素。方法回顾性分析164例单侧听神经瘤全切除且面神经结构完整保留病人的临床资料。采用House-Brackmann(HB)分级评价术后8 d和1年的面神经功能,运用Logistic回归筛选影响术后面神经功能的风险因素。结果单变量Logistic回归分析显示:中大型肿瘤、囊性肿瘤、前位和上位面神经、面神经与肿瘤重度黏连与面神经功能受损相关(P<0.01);而术后1年面神经功能损伤情况与各临床因素之间均无相关性(P>0.05)。多变量Logistic回归分析显示:中大型肿瘤、面神经与肿瘤重度黏连是术后8 d面神经功能受损的独立危险因素(P<0.05)。术后8 d面神经功能良好119例,受损45例;术后1年面神经功能良好140例,受损24例。结论术后8 d面神经功能受损程度不能预测病人术后远期面神经功能受损情况。Objective To explore the factors influencing the prognosis of facial nerve function after surgical resection of acoustic neuroma.Methods Clinical data of 164 unilateral acoustic neuroma patients with both total tumor removal and facial nerve anatomic preservation were analyzed retrospectively.The facial function 8 days and 1 year after surgery was assessed by House-Brackmann（HB）scale,and Logistic regression was used to select the risk factors influencing the facial nerve function after surgery.Results Univariate logistic regression showed that medium-large tumors,cystic tumors,anterior-superior tumors and severe adhesion with facial nerve were associated with facial nerve injury（P 〈0.01）;and there was no correlation between the clinical factors and the injury of facial nerve function 1 year after operation（P 〉0.05）.Multivariate logistic regression analysis showed that the large tumor and severe adhesion with facial nerve were the independent risk factors for facial nerve function 8 days after operation（P 〈0.05）.The facial nerve function was good in 119 patients and impaired in 45 on the day 8 after operation,while good in 140 and impaired in 24 in 1 year after operation.Conclusion The damage degree of facial nerve function 8 days after surgery cannot predict the damage severity of postoperative long-term facial nerve function.

关 键 词：神经瘤 听 面神经功能 显微外科手术 

分 类 号：R739.4[医药卫生—肿瘤]