经额外侧入路与双侧额下入路切除治疗大型嗅沟脑膜瘤的疗效比较  

Comparison of the efficacy of frontolateral approach and bifrontal approach in the treatment of giant olfactory groove meningioma

作　　者：尼占洪 陈辉 王德群 宋孝政 NI Zhanhong;CHEN Hui;WANG Dequn;SONG Xiaozheng(Department of Neurosurgery,the First People’s Hospital of Zhumadian,Zhumadian 463000,He’nan,China)

机构地区：[1]驻马店市第一人民医院神经外科

出　　处：《癌症进展》2020年第3期293-296,共4页Oncology Progress

摘　　要：目的比较经额外侧入路与传统双侧额下入路切除治疗大型嗅沟脑膜瘤的疗效。方法将80例大型嗅沟脑膜瘤患者依据手术入路方式不同分为经额外侧入路组(36例)和双侧额下入路组(44例),比较两组患者手术切除效果、临床症状、功能状态评分(KPS),随访10个月,比较两组患者并发症发生率及复发率。结果术后,两组患者头痛、嗅觉减退、视觉障碍及精神异常比例均降低(P﹤0.05),且经额外侧入路组嗅觉减退比例高于双侧额下入路组,视觉障碍比例低于双侧额下入路组(P﹤0.05)。两组患者术后1个月及术后6个月KPS评分均高于本组术前(P﹤0.05)。经额外侧入路组患者并发症总发生率低于双侧额下入路组(P﹤0.05)。两组患者Simpson分级、复发率及术前、术后1个月、术后6个月KPS评分比较,差异均无统计学意义(P﹥0.05)。结论经额外侧入路与双侧额下入路切除治疗大型嗅沟脑膜瘤均具有较好的手术切除效果,但双侧额下入路改善嗅觉功能更加优异,经额外侧入路改善视觉功能更加优异,创伤性更小,能够降低并发症。Objective To explore and compare the efficacy of frontolateral approach and bifrontal approach in the treatment of giant olfactory groove meningioma.Method This retrospective analysis included 80 patients with giant olfactory groove meningioma,who were further divided by respective procedures administered asfrontolateral approach group(n=36)and bifrontal approach group(n=44),the effect of surgery,clinical symptoms,and Karnofsky performance status scale(KPS)scores were assessed and compared between the two groups,additionally,the incidence and recurrence rates of complications between the two groups after 10 months follow-up were also evaluated.Result After surgery,the proportion of patients with headache,hyposmia,visual impairment,and mental disorders decreased significantly(P<0.05),notably,higher percentage of hyposmia and lower rate of visual impairment were observed in frontolateral approach group versus bifrontal approach group(P<0.05).The KPS scores of the two groups in 1 month and 6 months after surgery were significantly higher than those before(P<0.05).The overall incidence of complications in the frontolateral approach group was significantly lower than that in the bifrontal approach group(P<0.05).No significant differences were presented in regard to the Simpson classification,recurrence rate,as well as the KPS score before surgery,and in 1 or 6 months after surgery between the two groups(P>0.05).Conclusion The frontolateral approach and bifrontal approach have been proved to exhibit fairly good surgical effect in the treatment of giant olfactory groove meningioma,while the bifrontal approach offers better improvement for the olfactory function,although the frontolateral approach may ameliorate the visual function with lesstraumatic outcome,which significantly reduces the complications.

关 键 词：经额外侧入路 双侧额下入路 大型嗅沟脑膜瘤 

分 类 号：R739.41[医药卫生—肿瘤]