内镜经鼻入路手术对前颅底沟通性脑膜瘤患者生活质量的影响因素分析  

Impact of endoscopic endonasal approach on quality of life in patients with anterior skull base intra-extracranial extension meningioma

作　　者：刘俊其[1] 王振霖[1] 张秋航[1,2] 齐岩[1] 严波[1] 危维[1] 杨晓彤[1] Liu Junqi;Wang Zhenlin;Zhang Qiuhang;Qi Yan;Yan Bo;Wei Wei;Yang Xiaotong(Department of Otorhinolaryngology Head and Neck Surgery,Skull Base Surgery Center,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院耳鼻咽喉头颈外科颅底外科中心,北京100053 [2]首都医科大学宣武医院神经外科,北京100053

出　　处：《中华耳鼻咽喉头颈外科杂志》2022年第8期923-930,共8页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的总结内镜经鼻入路手术治疗前颅底沟通性脑膜瘤的经验并对患者的生活质量进行分析,探讨治疗的安全性和有效性。方法回顾分析2007年10月至2019年10月间,首都医科大学宣武医院收治的前颅底沟通性脑膜瘤患者83例,内镜经鼻入路手术前后分别采用前颅底肿瘤生活质量量表(Anterior Skull Base Questionnaire,ASBQ)评估患者的生活质量,并对手术方法、肿瘤切除程度、术后并发症和患者的生活质量变化规律进行总结和分析。采用SPSS 23.0软件进行统计学分析。结果根据纳入和排除标准,最终入组57例前颅底沟通性脑膜瘤患者,其中男23例,女34例,年龄(48.6±16.6)岁;50例(87.7%)达到或超过SimpsonⅠ级切除,7例次全切除。症状缓解情况:头痛缓解45/50(90%),视力改善18/19(94.7%),嗅觉改善6/45(13.3%),精神症状改善3/9(33.3%),癫痫发作改善5/7(71.4%)。术后并发症:精神症状5例,脑脊液漏2例,癫痫2例,额叶出血1例,颅内感染1例。随访时间38~144个月,2例患者复发,无死亡病例。经ASBQ评估,患者术后1个月的一般状况、躯体功能、角色功能、情绪障碍、疼痛、视力障碍、睡眠紊乱较术前均有明显改善,此后持续改善,并在术后6个月达到稳定水平。结论内镜经鼻入路手术可为前颅底沟通性脑膜瘤实现安全、有效的肿瘤切除效果,患者的生活质量可获得持续稳定的提高。Objective To summarize the experience of endoscopic endonasal approach in the treatment of anterior skull base with intra-extracranial extension meningioma,and to analyze the perioperative quality of life of patients,and to discuss the safety and efficacy of the treatment.Methods A total of 83 cases of anterior skull base with intra-extracranial extension meningioma admitted to Xuanwu Hospital,Capital Medical University from October 2007 to October 2019,who underwent endoscopic endonasal approach tumor resection,were retrospectively analyzed.The quality of life of the patients were evaluated by Anterior Skull Base Questionnaire(ASBQ)before and after surgery.The surgical techniques,extent of tumor resection,postoperative complications and the changes of patients′quality of life were summarized and analyzed.SPSS 23.0 software was used for statistical analysis.Results A total of 57 anterior skull base with intra-extracranial extension meningioma patients were enrolled according to the inclusion and exclusion criteria,including 23 males and 34 females,aging(48.6±16.6)years.Fifty cases(87.7%)reached or exceeded Simpson gradeⅠresection,and 7 cases underwent subtotal resection.Symptoms relief was as follows:headache relief in 45/50(90%),vision improvement in 18/19(94.7%),olfaction improvement in 6/45(13.3%),mental symptoms improvement in 3/9(33.3%),and seizure relief in 5/7(71.4%).Postoperative complication included mental symptoms in 5 cases,cerebrospinal fluid leakage in 2 cases,epilepsy in 2 cases,frontal lobe hemorrhage in 1 case,and intracranial infection in 1 case.The follow-up period was 38 to 144 months.There were two cases recurring and no death.ASBQ assessment showed significant improvement in general condition,physical function,role function,mood disorder,pain,vision impairment,and sleep disturbance at 1 month postoperatively,with continued improvement thereafter,and reached stable at 6 months postoperatively.Conclusion Endoscopic endonasal approach surgery is able to achieve safe and effective tumor res

关 键 词：前颅底 内镜 脑膜瘤 量表 生活质量 

分 类 号：R739.45[医药卫生—肿瘤]