显微镜下锁孔手术治疗大脑凸面脑膜瘤对患者认知功能的影响  

Effects of Endoscopic Keyhole Surgery on Cognitive Function of Cerebral Convexity Meningiomas

作　　者：杨志明[1] 廖晓灵[2] 胡帮红[1] 杨波[1] YANG Zhiming;LIAO Xiaoling;HU Banghong(Chongzhou People＇s Hospital,Chongzhou,611230)

机构地区：[1]四川省崇州市人民医院,611230 [2]四川省人民医院,610072

出　　处：《实用癌症杂志》2018年第9期1535-1538,共4页The Practical Journal of Cancer

摘　　要：目的探讨显微镜下锁孔手术治疗大脑凸面脑膜瘤对患者认知功能的影响。方法选取86例大脑凸面脑膜瘤患者作为研究对象,根据手术入路方式的不同分为观察组50例与对照组36例。观察组采用额外侧前颅底锁孔入路显微镜下手术治疗,对照组采用经眉弓眶上锁孔入路显微镜下手术治疗。记录手术效果与认知功能变化情况。结果所有患者都顺利完成手术。观察组全切除45例,次全切除5例;对照组全切除20例,次全切除16例;2组切除方式对比差异有统计学意义(P<0.05)。观察组术后14 d的尿崩、感染、垂体功能减退、下丘脑损伤等并发症发生率为8.0%,显著低于对照组的33.3%(P<0.05)。术后3个月观察组与对照组的认知功能评分分别为(7.43±2.14)分和(5.89±1.34)分,都明显高于术前1 d的(3.56±1.33)分和(3.48±1.28)分(P<0.05),且观察组术后3个月的评分明显高于对照组(P<0.05)。结论相对于经眉弓眶上锁孔入路,额外侧前颅底锁孔入路显微镜下手术治疗大脑凸面脑膜瘤有利于进行肿瘤全切,减少术后并发症的发生,促进认知功能的恢复。Objective To investigate the effects of endoscopic keyhole surgery on cognitive function of cerebral convexity meningiomas. Methods 86 patients with cerebral convex meningioma were selected and divided into the observation group（ 50 cases） and the control group（ 36 cases）,according to the different surgical approach. The observation group was given additional lateral anterior skull base keyhole surgery under microscope,the control group was treated by supraorbital eyebrow surgical treatment of microscope,recorded the operation effect changes and cognitive function. Results All the patients completed the operation successfully. The observation group received total resection of 45 cases,subtotal resection of 5 cases; and there were 20 cases of total resection and 16 cases of subtotal resection in the control group,there had significant difference（ P〈0. 05）. The postoperative 14 d of infection,diabetes insipidus,hypopituitarism,hypothalamic injury and complication rate in the observation group was8. 0%,and 33. 3% in the control group,（ P〈0. 05）. The postoperative 3 months of cognitive function scores in the observation group and the control group were 7. 43 ± 2. 14 points and 5. 89 ± 1. 34 points,which were significantly higher than the preoperative 1 d of 3. 56 ± 1. 33 points and 3. 48 ± 1. 28 points（ P〈0. 05）,and the patients in the observation group was significantly higher than the control group（ P〈0. 05）. Conclusion Compared with the supraorbital keyhole approach,additional lateral anterior skull base keyhole microsurgical treatment for cerebral convex meningioma is better for total resection of tumor,it can reduce the incidence of postoperative complications and promote the recovery of cognitive function.

关 键 词：锁孔手术 显微镜 大脑凸面脑膜瘤 认知功能 入路 

分 类 号：R739.45[医药卫生—肿瘤]