显微外科手术不同入路对颅前窝底脑膜瘤患者肿瘤有效切除率、神经功能、并发症及生活质量的影响  

Effects of different approaches of microsurgery on effective tumor resection rate,neurological function,complications and quality of life in patients with anterior cranial fossa meningiomas

作　　者：曹晓磊 顾倩[1] 邵晶 CAO Xiaolei;GU Qian;SHAO Jing(Department of Neurosurgery,East Hospital of Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院东院神经外科,上海200040

出　　处：《陕西医学杂志》2023年第4期433-436,共4页Shaanxi Medical Journal

基　　金：上海市卫生健康委员会科研课题(202040069);复旦大学附属华山医院科研启动基金资助项目(20132028)。

摘　　要：目的:探究显微外科手术不同入路对脑膜瘤患者肿瘤有效切除率、神经功能、并发症及生活质量的影响。方法:选择90例颅前窝底脑膜瘤患者资料,根据入路方式分为观察组和对照组,对照组(n=43)行额下入路手术,观察组(n=47)行经眶-额窦入路手术,比较两组围手术期指标、肿瘤有效切除率、术后并发症。术后2、4周神经功能[格拉斯哥昏迷评分(GCS)、中文版癌症治疗功能评估-认知功能量表(FACT-Cog)]及生活质量[肿瘤患者卡氏(KPS)评分表]。结果:观察组手术时间、术中出血量、住院时间均显著低于对照组(P<0.05);观察组有效切除率为93.62%,显著高于对照组的79.07%(P<0.05);观察组术后并发症率为8.51%,对照组为18.60%,比较差异无统计学意义(P>0.05);与术前比较,两组术后2、4周GCS、FACT-Cog评分均显著升高(均P<0.05),观察组术后GCS、FACT-Cog评分显著高于对照组(均P<0.05);两组术后1、3个月KPS评分显著升高(均P<0.05),观察组术后KPS评分显著高于对照组(均P<0.05)。结论:与额下入路比较,经眶-额窦入路具有术时短、创伤小、术后并发症少等优势,且肿瘤有效切除率更高,患者术后神经功能恢复快,整体生活质量更高。Objective:To explore the effects of different microsurgical approaches on the effective tumor resection rate,neurological function,complications and quality of life in patients with meningiomas.Methods:The data of 90 patients with anterior cranial fossa meningiomas were retrospectively analyzed.According to the approaches,the patients were divided into observation group and control group.The control group(n=43)underwent subfrontal approach surgery,while the observation group(n=47)underwent transorbital-frontal sinus approach surgery.The perioperative indicators,effective tumor resection rate and postoperative complications as well as neurological function(GCS,FACT-Cog)and quality of life(KPS)at 2 and 4 weeks after surgery were compared between the two groups.Results:The surgical time,intraoperative blood loss and hospital stay in observation group were significantly shorter or less than those in control group(all P<0.05).The effective resection rate in observation group was 93.62%,which was significantly higher than 79.07%in control group(P<0.05).The total incidence rate of postoperative complications was 8.51%in observation group and 18.60%in control group(P>0.05).Compared with before surgery,the GCS score and FACT-Cog score of the two groups were significantly increased at 2 and 4 weeks after surgery,and the scores in observation group after surgery were significantly higher than those in control group(all P<0.05).The KPS scores of both groups at 1 month and 3 months after surgery were significantly enhanced,and the KPS scores in observation group were significantly higher than those in control group after surgery(all P<0.05).Conclusion:Compared with subfrontal approach,transorbital-frontal sinus approach has the advantages of shorter surgical time,smaller trauma,fewer postoperative complications,higher effective tumor resection rate,faster postoperative neurological function recovery and higher overall quality of life.

关 键 词：颅前窝底 脑膜瘤 肿瘤切除 显微外科 神经功能 生活质量 

分 类 号：R739.41[医药卫生—肿瘤]