不同手术入路对鞍区脑膜瘤患者生活质量及并发症的影响  

Effect of different operative routes on quality of life and complications in patients with meningioma in the sellar region

作　　者：张永成 白西民 ZHANG Yong-cheng;BAI Xi-min(Department of Neurosurgery,People＇s Hospital Huazhou District,Weinan 714100,China;Department of Neurosurgery,Weinan Central Hospital,Weinan 714100,China)

机构地区：[1]陕西省渭南市华州区人民医院神经外科,渭南714100 [2]陕西省渭南市中心医院神经外科,渭南714100

出　　处：《中国肿瘤临床与康复》2018年第10期1196-1199,共4页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：西安市科学技术局项目(2015SF-0708)

摘　　要：目的探讨不同手术入路对鞍区脑膜瘤患者术后生活质量及并发症的影响。方法选取2013年1月至2017年1月间渭南市华州区人民医院收治的61例鞍区脑膜瘤患者,根据手术入路方式不同分为翼点入路组(21例)、额下入路组(20例)和纵裂入路组(20例),比较三组患者肿瘤切除程度、术后并发症、术后复发率及术后生活质量。结果三组患者根治性切除率分别为71.4%、65.0%和75.0%,差异无统计学意义(P>0.05)。纵裂入路组患者术后并发症发生率低于翼点入路组和额下入路,差异均有统计学意义(均P<0.05)。三组患者术后格拉斯哥昏迷指数(GCS)评分均上升,且纵裂入路组患者评分高于额下入路组和翼点入路组,差异均有统计学意义(均P<0.05)。三组患者术后3个月、6个月和12个月生活质量评分均升高,且纵裂入路组患者评分高于额下入路和翼点入路组,差异均有统计学意义(均P<0.05)。结论鞍区脑膜瘤患者经纵裂入路手术切除治疗,可降低并发症发生率,缓解临床症状,减轻神经损伤,改善术后生活质量。Objective To investigate the effect of different operative routes on quality of life and complications in patients with meningioma in the sellar region. Methods From January 2013 to January2017,61 patients with meningioma in the sellar region who were treated at People＇s Hospital Huazhou District were selected. According to the different operative routes,they were divided into pterional approach group（ 21 patients）,subtemporal approach group（ 20 patients）,and interhemispheric fissure group（ 20 patients）. Resection degree,postoperative complications,recurrence rate after surgery and quality of life were compared among the three groups. Results The radical resection rate was 71. 4%,65. 0%,and75. 0% respectively for the three groups（ P〉0. 05）. The incidence of postoperative complications was significantly lower in the interhemispheric fissure group than in the pterional approach group and the subtemporal approach group（ all P〈0. 05）. The GCS scores increased in the three groups significantly after operation and the GCS scores were significantly higher in the interhemispheric fissure approach group than in the subtemporal approach group and the pterional approach group（ P〈0. 05）. The Karnofsky performance score（ KPS） scores increased significantly in the three groups at 3,6 and 12 months after the operation（ all P〈0. 05）. with the interhemispheric fissure group significantly higher than the other two groups（ all P〈0. 05）. Conclusion Surgical resection through the interhemispheric fissure approach can reduce the incidence of complications,relieve the clinical symptoms,alleviate the nerve injuries,and improve the quality of life in patients with meningioma in the sellar region.

关 键 词：脑膜瘤 手术入路 并发症 生活质量 

分 类 号：R739.45[医药卫生—肿瘤]