神经内镜辅助多技术联合在乙状窦后锁孔入路听神经瘤切除术中的临床应用  

Clinical application of neuroendoscopy assisted multi-technology in combination in retrosigmoid keyhole approach of acoustic neuroma resection

作　　者：李海红[1] 宋国智[1] LI Haihong;SONG Guozhi(the Fifth Department of Neurosurgery,Handan Central Hospital in Hebei Province,Handan,Hebei,056001)

机构地区：[1]河北省邯郸市中心医院神经外五科,河北邯郸056001

出　　处：《实用临床医药杂志》2022年第2期31-33,37,共4页Journal of Clinical Medicine in Practice

基　　金：河北省邯郸市科学技术研究与发展计划(19422083009-3)。

摘　　要：目的探讨锁孔乙状窦后入路(RSA)下听神经瘤(AN)切除术中应用神经内镜辅助多技术联合方法的临床效果。方法选取经锁孔RSA行切除术AN患者84例为研究对象。根据手术方法的不同,分为对照组40例和观察组44例。对照组采用传统显微镜下切除术治疗,观察组采用神经内镜辅助下显微镜切除术治疗联合神经电生理监测和超声骨刀技术。比较2组手术全切率、面神经功能保留率及术后并发症发生情况。结果观察组肿物全切率高于对照组,差异有统计学意义(P<0.05)。术后6个月,观察组面神经功能保留率高于对照组,差异有统计学意义(P<0.05);观察组术后并发症总发生率为6.8%,低于对照组的22.5%,差异有统计学意义(P<0.05)。结论神经内镜辅助多技术联合在乙状窦后锁孔入路AN切除术中应用能够有效提高肿瘤全切率,减少术中面神经损伤,在术后面神经功能保留方面效果较佳,并可降低术后并发症总发生率。Objective To explore clinical effect of neuroendoscopy assisted multi-technology in combination in keyhole retrosigmoid approach(RSA)of acoustic neuroma resection.Methods A total of 84 patients with AN underwent keyhole RSA resection were selected as study subjects.According to different surgical methods,they were divided into control group(40 cases)and observation group(44 cases).The control group was treated with traditional microscope resection,and the observation group was treated with neuroendoscope assisted microscope resection combined with neuroelectrophysiological monitoring and ultrasonic bone knife technique.Total resection rate,facial nerve function retention rate and postoperative complications were compared between the two groups.Results The total resection rate of tumor in the observation group was significantly higher than that in the control group(P<0.05).Six months after surgery,the facial nerve function retention rate in the observation group was significantly higher than that in the control group(P<0.05).The total incidence of postoperative complications in the observation group was 6.8%,which was significantly lower than 22.5%in the control group(P<0.05).Conclusion Neuroendoscopy assisted multi-technologycombination in retrosigmoid keyhole approach of AN resection can effectively improve the total tumor resection rate and reduce intraoperative facial nerve injury.It has better effect on facial nerve function preservation after operation and can reduce the total incidence of postoperative complications.

关 键 词：听神经瘤 乙状窦后锁孔入路 神经内镜 面神经 

分 类 号：R429[医药卫生—临床医学] R61