经眶上外侧入路与经额下入路手术治疗前颅窝底脑膜瘤的效果比较  

Comparison of Curative Effect between Supranolateral Orbital Approach and Subfrontal Approach in the Treatment of Anterior Cranial Fossa Base Meningiomas

作　　者：罗杰[1] 周帆[1] 黄云峰[1] 袁金刚 陈风 李帆 LUO Jie;ZHOU Fan;HUANG Yunfeng;YUAN Jingang;CHEN Feng;LI Fan(Huanggang Central Hospital,Huanggang 438000,China)

机构地区：[1]黄冈市中心医院,湖北黄冈438000 [2]麻城市白果中心卫生院

出　　处：《中外医学研究》2021年第22期63-65,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较经眶上外侧入路与经额下入路手术治疗前颅窝底脑膜瘤的临床效果。方法:回顾性分析黄冈市中心医院神经外科2017年2月-2019年6月行手术治疗的70例前颅窝底脑膜瘤患者病历资料,根据手术入路不同分为经眶上外侧入路组(35例)和经额下入路组(35例)。比较两组患者手术操作时间、术中出血量、肿瘤全切率、术后住院时间等手术相关指标;采用美国国立卫生研究院卒中量表(NIHSS)、中国卒中神经功能缺损程度评分量表(NDS)评估两组患者术前及术后1周神经功能变化,详细记录两组患者脑水肿、低钠血症、发热、颅内感染等并发症发生情况。结果:经眶上外侧入路组术中出血量少于经额下入路组,肿瘤全切率高于经额下入路组,手术操作时间和术后住院时间均短于经额下入路组,差异有统计学意义(P<0.05);两组患者术前NIHSS、NDS评分比较差异无统计学意义(P>0.05),两组患者术后1周NIHSS、NDS评分均下降,差异有统计学意义(P<0.05),且经眶上外侧入路组术后1周NIHSS、NDS评分低于经额下入路组,差异有统计学意义(P<0.05);经眶上外侧入路组脑水肿、低钠血症、发热、颅内感染等并发症发生率低于经额下入路组,差异有统计学意义(P<0.05)。结论:经眶上外侧入路手术治疗颅前窝底脑膜瘤的疗效优于经额下入路,神经功能恢复好,并发症发生率低。Objective:To compare the clinical efficacy of supranolateral orbital approach and subfrontal approach in the treatment of anterior cranial fossa base meningiomas.Method:Medical records of 70 patients with anterior cranial fossa base meningiomas who underwent surgical treatment in the department of neurosurgery of Huanggang Central Hospital from February 2017 to June 2019 were retrospectively analyzed.They were divided into the supralateral orbital approach group (35 cases) and the subfrontal approach group (35 cases) according to different surgical approaches.The operation-related indexes such as the operative time,intraoperative blood loss,total tumor resection rate,postoperative hospital stay between the two groups were compared.The neurological function changes of the two groups before and one week after surgery were evaluated by national institutes of health stroke scale (NIHSS) and neurological deficit scale (NDS),and the incidence of complications such as cerebral edema,hyponatremia,fever and intracranial infection of the two groups were recorded in detail.Result:The intraoperative blood loss of the supranolateral orbital approach group was less than that of the subfrontal approach group,the total tumor resection rate was higher than that of the subfrontal approach group,and the operative time and postoperative hospital stay were shorter than that of the subfrontal approach group,the differences were statistically significant (P<0.05).There were no statistically significant differences in NIHSS and NDS scores between the two groups before surgery (P>0.05),but the NIHSS and NDS scores of the two groups decreased after surgery of one week (P<0.05),and the NIHSS and NDS scores of the supracolateral orbital approach group were lower than those of the subfrontal approach group,the differences were statistical significance (P<0.05).The incidence of complications such as brain edema,hyponatremia,fever,intracranial infection of the supranolateral orbital approach group was lower than that of the subfrontal approach

关 键 词：经眶上外侧入路 经额下入路 前颅窝底脑膜瘤 

分 类 号：R739.45[医药卫生—肿瘤]