眶上外侧入路与额底入路在颅前窝底脑膜瘤切除手术中的应用  

Application of supraorbital lateral approach and frontal base approach in resection of anteri⁃or fossa base meningioma

作　　者：吴国培 唐永峰 陈宋育 Wu Guopei;Tang Yongfeng;Chen Songyu(Department of Neurosurgery,Rich Hospital Affiliated to Nantong University,Nantong Rich Hospital,Nantong 226010,China;Department of Neurosurgery,Nanjing Jiangbei People's Hospital,Nanjing 210000,China;Department of Neurosurgery,The Tenth People's Hospital Affiliated to Tongji University,Shanghai 200072,China)

机构地区：[1]南通大学附属瑞慈医院南通瑞慈医院神经外科,南通226010 [2]南京江北人民医院神经外科,南京210000 [3]同济大学附属第十人民医院神经外科,上海200072

出　　处：《广西医科大学学报》2021年第8期1599-1603,共5页Journal of Guangxi Medical University

摘　　要：目的:探讨两种入路方式在颅前窝底脑膜瘤切除手术中的应用效果,并分析其对患者炎性因子、髓鞘碱性蛋白(MBP)、E26转录因子-1(ETS-1)的影响。方法:回顾性分析2016年4月至2019年1月符合纳入标准的102例颅前窝底脑膜瘤患者病历资料,根据不同手术入路方式分组,观察组59例,采用眶上外侧入路;对照组43例,采用额底入路;对两组手术及术后恢复情况,术前、术后72 h炎性因子及MBP、ETS-1水平变化,并发症发生情况进行比较。结果:两组肿瘤全切率比较,差异无统计学意义(P>0.05)。与对照组比较,观察组术中出血量、手术时间、术后卧床时间、术后住院时间明显较少或较短(P<0.05);术后72 h血清超敏-C反应蛋白(hs-CRP)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、血清MBP、ETS-1水平明显降低(P<0.05);观察组并发症发生率6.78%,明显低于对照组的20.93%(P<0.05)。结论:在颅前窝底脑膜瘤切除手术中,眶上外侧入路与额底入路均可获得良好肿瘤切除效果,眶上外侧入路能减少术中出血,缩短手术及术后恢复时间,减轻手术对炎性因子及MBP、ETS-1水平的影响,减少并发症发生。Objective:To investigate the application effect of two approaches in the resection of anterior fossa base meningioma,and to analyze the effect of these approaches on the inflammatory factors,myelin basic protein(MBP)and E26 transcription factor-1(ETS-1).Methods:Clinical data of 102 patients with anterior cranial fossa base meningioma from April 2016 to January 2019 were retrospectively analyzed.The patients were divided into an observation group(n=59)and a control group(n=43)according to different surgical approaches.The patients in the observation group received supraorbital lateral approach,whereas those in the control group received frontal base approach.The operation and postoperative recovery,the inflammatory factors,MBP,and ETS-1 levels before and after 72 h of surgery,and the occurrence of complications were compared between the two groups.Results:There was no significant difference in the total tumor resection rate(P>0.05).The intraoperative blood loss,operative time,postoperative bed time and postoperative hospital days in the observation group were significantly less or shorter than those in the control group(P<0.05).After 72h of the operation,the levels of serum hypersensitive C-reactive protein(HS-CRP),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),MBP and ETS-1 in the observation group were significantly lower(P<0.05).The incidence of complications in the observation group was 6.78%,which was significantly lower than that in the control group(20.93%)(P<0.05).Conclusion:Both supraorbital lateral approach and frontal base approach in resection of anterior fossa base meningioma can achieve good results.The supraorbital lateral approach can reduce intraoperative bleeding,shorten the operation and postoperative recovery time,reduce the impact of surgery on inflammatory factors,MBP and ETS-1 levels,and reduce complications.

关 键 词：脑膜瘤 入路方式 炎性因子 髓鞘碱性蛋白 E26转录因子-1 

分 类 号：R739.45[医药卫生—肿瘤]