神经导航结合术中神经电生理监测在治疗脑干肿瘤的疗效分析  

The efficacy of neuronavigation combined with intraoperative neuroelectrophysiological monitoring in the treatment of brain stem tumors

作　　者：王利清[1] 王宇[1] 李达[1] 胡安明[1] 孙炜[1] WANG Li-qing;WANG Yu;LI Da;HU An-ming;SUN Wei(Department of Neurosurgery,Beijing Bo ai Hospital,China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]中国康复研究中心北京博爱医院神经外科,北京100068

出　　处：《川北医学院学报》2019年第1期12-15,共4页Journal of North Sichuan Medical College

基　　金：中央级公益性科研院所基本科研业务费专项资金项目(2016CZ-4)

摘　　要：目的:探究术前神经导航结合术中电生理监测在治疗成人脑干肿瘤的临床应用效果,以期为临床中手术方式的选择提供参考。方法:根据患者手术方式的不同,将62例脑干肿瘤患者分为观察组(n=37)和对照组(n=25);观察组患者采用术前神经导航联合术中神经电生理监测,对照组采用术中使用神经电生理监测。比较两组患者平均住院时间和术后症状变化情况;分析比较两组患者术前24 h及术后3个月的NIHSS评分和ADL评分;比较两组患者术后并发症的发生率。结果:观察组患者术后症状好转人数比例高于对照组,比较差异具有统计学意义(P<0.05);两组患者术后症状无变化、症状加重和出现新发症状的比例比较,差异无统计学意义(P>0.05);观察组患者平均住院时间显著低于对照组,差异具有统计学意义(P<0.05)。术后3个月,两组患者NIHSS评分均降低,但观察组患者降低程度比对照组更显著,差异有统计学差异(P<0.05);术后3个月,两组患者ADL评分均升高,但观察组患者升高程度较对照组更显著,差异有统计学差异(P<0.05)。两组患者术后出现皮下积液、脑水肿、脑积水和肺部感染等并发症的比例比较差异无统计学意义(P>0.05)。结论:神经导航联合术中神经电生理监测在治疗脑干肿瘤具有较好的临床疗效,且能增加远期生活质量,值得临床中推广应用。Objective:To explore the clinical effect of neuronavigation combined with intraoperative neuroelectrophysiological monitoring in the treatment of brain stem tumors,in order to provide reference for the selection of surgical methods in clinical practice.Methods:62 patients with brain stem tumors were divided into observation group(n=37) and control group(n=25) according to different surgical methods.The patients in observation group were monitored by preoperative neuronavigation combined with intraoperative neuroelectrophysiological monitoring,while the patients in control group were monitored by intraoperative neuroelectrophysiological monitoring.The average hospitalization time and postoperative symptoms of the two groups were compared,the NIHSS and ADL scores of the two groups were analyzed and compared 24 hours before operation and 3 months after operation,and the incidence of postoperative complications was compared between the two groups.Results:The proportion of patients with improved symptoms in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the proportion of postoperative symptoms,aggravation of symptoms and appearance of new symptoms in the two groups(P>0.05),the average length of stay in the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).3 months after surgery,NIHSS scores decreased in both groups,and the degree of reduction in the observation group was higher than that in the control group(P<0.05).3 months after surgery,the ADL scores increased in both groups,and degree of increase in the observation group was more significant than that in the control group,with a statistically significant difference(P<0.05).There was no significant difference in the proportion of complications(such as subcutaneous fluid,brain edema,hydrocephalus and pulmonary infection) between the two groups(P>0.05).Conclusion:Neuronavigatio

关 键 词：神经导航 神经电生理监测 脑干肿瘤 疗效 

分 类 号：R739.41[医药卫生—肿瘤]