不同入路手术对颅底脑膜瘤患者的疗效差异及术后不良反应发生的危险因素分析  

The Difference of Curative Effect of Different Approaches in Patients with Skull Base Meningioma and the Risk Factors of Postoperative Adverse Reactions

作　　者：王果 王倩[1] 张月怡 WANG Guo;WANG Qian;ZHANG Yueyi(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2022年第12期1975-1979,共5页The Practical Journal of Cancer

摘　　要：目的分析不同入路手术对颅底脑膜瘤患者治疗的疗效差异,以及术后不良反应发生的危险性因素。方法将60例患者依照随机信封法分为眶上外侧入路组、翼点入路组、额下入路组,患者均依照分组采用不同方案治疗;记录各组术中出血量、术后住院时间、肿瘤切除程度、术后并发症、术后复发率;治疗前后采用NIHSS评分、GCS评分、NDS评分、KPS评分量表对患者进行评估;治疗前后检测患者血清中IGFPB-3、S100β蛋白水平。结果三组患者术中出血量、术后住院时间、术后并发症及肿瘤全切程度存在明显差异,且差异存统计学意义(P<0.05),眶上外侧入路组患者术中出血量、术后住院时间、术后并发症及术后复发率最低,肿瘤全切率最高;治疗后三组患者NIHSS评分及NDS评分均明显降低,GCS评分、KPS评分明显升高,且差异存统计学意义(P<0.05),治疗后眶上外侧入路组患者NIHSS评分及NDS评分最低,GCS评分、KPS评分最高;治疗后三组患者血中IGFPB-3、S100β水平存明显差异,且差异存统计学意义(P<0.05),其中眶上外侧入路组患者血中IGFPB-3、S100β水平最低;手术方式、肿瘤切除程度、NIHSS评分改善程度、GCS评分增加程度、NDS评分改善程度、KPS评分改善程度、IGFPB-3减少程度及S100β减少程度是影响患者术后不良反应发生的独立性影响因素(P<0.05)。结论采用眶上外侧入路可有效加速患者术后恢复,且手术方式、肿瘤切除程度、NIHSS评分、GCS评分、NDS评分、KPS评分、IGFPB-3及S100β水平是患者术后不良反应发生的独立性影响因素。Objective To analyze the therapeutic effect of different approaches in the treatment of skull base meningioma and the risk factors of postoperative adverse reactions.Methods A total of 60 patients were randomly divided into supra-lateral orbital approach group,pterional approach group and inferior frontal approach group.All patients were treated with different regimens according to the groups.The intraoperative blood loss,postoperative hospital stay,degree of tumor resection,postoperative complications and postoperative recurrence rate were recorded.NIHSS score,GCS score,NDS score and KPS score were used to evaluate the patients before and after treatment.Serum levels of IGFPB-3 and S100βwere detected before and after treatment.Results There were significant differences in intraoperative blood loss,postoperative hospital stay,postoperative complications and degree of total tumor resection among the three groups(P<0.05).The intraoperative blood loss,postoperative hospital stay,postoperative complications and postoperative recurrence rate were the lowest,and the total tumor resection rate was the highest in the supra-lateral orbital approach group(P<0.05).After treatment,the NIHSS score and NDS score of the three groups were significantly decreased,while the GCS score and KPS score were significantly increased,and the differences were statistically significant(P<0.05).After treatment,the NIHSS score and NDS score of patients in the supra-lateral orbital approach group were the lowest,and the GCS score and KPS score were the highest(P<0.05).After treatment,the levels of IGFPB-3 and S100βin blood of the three groups were significantly different,and the differences were statistically significant(P<0.05).The serum levels of IGFPB-3 and S100βwere the lowest in the supra-lateral orbital approach group.Surgical method,tumor resection degree,NIHSS score improvement degree,GCS score increase degree,NDS score improvement degree,KPS score improvement degree,IGFPB-3 reduction degree and S100βreduction degree were independe

关 键 词：翼点入路 额下入路 眶上外侧入路 疗效差异 术后不良反应 

分 类 号：R739.45[医药卫生—肿瘤]