不同手术体位对枕下乙状窦后入路听神经瘤切除术手术时间的影响  

Effect of different surgical positions on the operation time of acoustic neuroma resection through the suboccipital retrosigmoid approach

作　　者：翟亚兰 张晴[1] ZHAI Yalan;ZHANG Qing(Department of Neurosurgery,Zhongnan Hospital of Wuhan University,Hubei,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院神经外科,武汉市430071

出　　处：《河北医药》2023年第11期1654-1656,1660,共4页Hebei Medical Journal

基　　金：武汉大学中南医院护理学科培育项目(编号:HLXKPY202112)。

摘　　要：目的比较听神经瘤患者枕下乙状窦后入路术中传统侧俯卧摆体位、改良侧俯卧摆体位对手术时间的影响。方法研究对象来源于2020年5月至2022年5月住院的接受乙状窦后入路术治疗的100例听神经瘤患者,以随机法将其分组,对照组50例患者术中采取体位以传统侧俯卧摆体位为主,观察组50例患者术中采取体位以改良侧俯卧摆体位为主,比较2组手术时间、术中出血量、面部神经功能分级(HB分级)、小脑外1/3切除率、并发症总发生率。结果观察组治疗后HB分级Ⅰ级(30.00%)、Ⅱ级(50.00%)、Ⅲ级(18.00%)、Ⅳ级率(2.00%)与对照组(26.00%、48.00%、24.00%、2.00%)比较,差异无统计学意义(P>0.05)。术中出血量观察组与对照组比较,差异无统计学意义(P>0.05)。手术时间观察组短于对照组,小脑外1/3切除率观察组(12.00%)高于对照组(0),观察组并发症总发生率(2.00%)低于对照组(20.00%),差异均有统计学意义(P<0.05)。结论听神经瘤患者枕下乙状窦后入路手术中采取改良侧俯卧摆体位,可有效缩短手术时间,改善面部神经功能,降低并发症发生率,但会增加小脑切除风险。Objective To compare the effect of traditional lateral prone swing position versus modified lateral prone swing position on operation time of acoustic neuroma through the suboccipital retrosigmoid approach.Methods A total of 100 patients with acoustic neuroma hospitalized in our hospital from May 2020 to May 2022 and treated with acoustic neuroma resection through the suboccipital retrosigmoid approach were recruited.They were randomly divided into control group and observation group,with 50 patients in each group.The traditional side prone swinging position and modified side prone swinging position during the operation were given to patients of control group and observation group,respectively.The operation time,intraoperative blood loss,facial nerve function classification(HB classification),excision rate of external 1/3 of cerebellum,and the total incidence of complications were compared between the two groups.Results After treatment,there were no significant differences in the rates of HB gradeⅠ(30.00%vs 26.00%),gradeⅡ(50.00%vs 48.00%),gradeⅢ(18.00%vs 24.00%),and gradeⅣ(2.00%vs 2.00%),and intraoperative blood loss between observation group and the control group(P>0.05).The operation time in the observation group was significantly shorter than that in the control group.The excision rate of external 1/3 of cerebellum(12.00%vs 0)was significantly higher in the observation group than that in the control group,while the total incidence of complications was significantly lower(2.00%vs 20.00%),(P<0.05).Conclusion The modified lateral prone position can effectively shorten the operation time,improve the facial nerve function,and reduce the incidence of complications in patients with acoustic neuroma,although it increases the risk of cerebellar resection.

关 键 词：听神经瘤切除 枕下乙状窦后入路 手术体位 手术时间 

分 类 号：R651.1[医药卫生—外科学]