鼻内镜下鼻颅底肿瘤切除术与开放式入路手术治疗前颅底肿瘤的效果比较  

Effects of nasal endoscopic tumor resection and open approach surgery on anterior skull base tumors

作　　者：夏洪伟[1] 康瑞[1] 庞磊[1] Xia Hongwei;Kang Rui;Pang Lei(Department of Ear Nose and Throat,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]河南省周口市中心医院耳鼻喉科,466000

出　　处：《中国实用医刊》2020年第1期33-36,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨鼻内镜下鼻颅底肿瘤切除术与开放式入路对前颅底肿瘤患者神经功能、生活质量及术后并发症的影响.方法 选取2015年6月至2019年6月周口市中心医院收治的64例前颅底肿瘤患者,按照随机数表法分为观察组与对照组,每组32例.观察组采用鼻内镜下鼻颅底肿瘤切除术,对照组采用开放式入路手术.比较两组手术相关指标、神经功能缺损程度评定量表(CSS)评分、美国国立卫生院卒中量表(NIHSS)评分、简易精神状态量表(MMSE)评分、SF-36生活质量量表评分及术后并发症发生率.结果观察组术中出血量[(46.68±8.54)ml]少于对照组[(72.23±14.56)ml],术后意识恢复时间、卧床时间及住院时间[(2.24±0.42)、(7.20±1.88)、(14.76±2.95)d]短于对照组[(3.30±0.59)、(11.29±2.54)、(20.08±3.24)d],差异有统计学意义(P<0.05);术后1个月观察组CSS评分、NIHSS评分低于对照组,MMSE评分、SF-36生活质量评分高于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为6.25%(2/32),低于对照组的25.00%(8/32),P<0.05.结论 与开放式入路手术比较,鼻内镜下鼻颅底肿瘤切除术可减轻手术创伤,促进患者术后恢复及神经功能改善,提高患者生活质量,且术后并发症发生率较低.Objective To investigate the effects of nasal endoscopic tumor resection and open approach surgery on neurological function,quality of life and postoperative complications of patients with anterior skull base tumors.Methods Sixty-four patients with anterior skull base tumors who were admitted to Zhoukou Central Hospital from June 2015 to June 2019 were selected.They were divided into the observation group and control group according to random number table method,with 32 cases in each group.The observation group was treated by endoscopic nasal skull base tumor resection,while the control group was treated by open approach surgery.Related indicators of surgery,scores of China Stroke Scale(CSS),American National Institute of Health Stroke Scale(NIHSS),Mini-Mental State Examination(MMSE)and SF-36 Quality of Life Scale,and the incidence of postoperative complications were compared between the two groups.Results The intraoperative blood loss of observation group was(46.68±8.54)ml,which was significantly less than(72.23±14.56)ml of control group(P<0.05).The postoperative recovery time,time in bed and hospital stay of observation group were(2.24±0.42)d,(7.20±1.88)d,(14.76±2.95)d,respectively,which were significantly shorter than the(3.30±0.59)d,(11.29±2.54)d,(20.08±3.24)d of control group(P<0.05).The CSS and NIHSS scores of observation group 1 month after surgery were significantly lower than those of control group,the MMSE score and SF-36 Quality of Life Scale score were significantly higher than those of control group(P<0.05).The incidence of postoperative complications in observation group was 6.25%(2/32),which was significantly lower than 25.00%(8/32)in control group(P<0.05).Conclusions Compared with the open approach surgery,nasal endoscopic resection of the skull base tumor can reduce surgical trauma,promote postoperative recovery and improvement of neurological function,improve the quality of life of patients,with lower incidence of postoperative complications.

关 键 词：生活质量 术后并发症 鼻内镜 前颅底肿瘤 神经功能 

分 类 号：R73[医药卫生—肿瘤]