听神经瘤质地与手术疗效的关系  

The relationship between the texture of vestibular schwannoma and the therapeutic effect of surgery

作　　者：马全锋[1] 王宏[1] Ma Quanfeng;Wang Hong(Department of Neurosurgery,Tianjin Huanhu Hospital,Tianjin 300350,China)

机构地区：[1]天津市环湖医院神经外科,天津300350

出　　处：《中华神经外科杂志》2023年第8期772-776,共5页Chinese Journal of Neurosurgery

摘　　要：目的探讨不同质地听神经瘤的临床特征及手术疗效。方法回顾性分析2017年1月至2021年12月天津市环湖医院神经外科连续收治的116例中、大型听神经瘤患者的临床资料。按照肿瘤性质分为囊性组39例(33.6%)与实性组77例(66.4%)。分析比较两组患者的临床特征、肿瘤切除程度、术后并发症、面神经功能良好率(House-Brackmann分级Ⅰ、Ⅱ级)以及肿瘤复发率等;并分别在Koos分级Ⅲ级和IV级患者中比较囊性组与实性组的临床疗效。结果囊性组较实性组患者病程短、肿瘤最大径长、Koos分级高,差异均具有统计学意义(均P<0.05)。两组患者的术后并发症发生率、随访时间、出院时和末次随访时面神经功能良好率以及复发率的差异均无统计学意义(均P>0.05)。囊性组的全切除率较实性组低[分别为30.8%(12/39)和71.4%(55/77)],差异具有统计学意义(P<0.001)。Koos分级Ⅲ级(囊性组7例,实性组32例)和IV级(囊性组32例,实性组45例)的患者中,囊性组均较实性组的肿瘤全切除率低(均P<0.05);囊性组与实性组术后并发症发生率、随访时间、出院时和末次随访时面神经功能良好率以及复发率的差异均无统计学意义(均P>0.05)。结论中、大型听神经瘤患者中,囊性听神经瘤具有生长快、病程短的临床特点,肿瘤全切除率较实性肿瘤偏低,术后并发症、面神经功能良好率和复发率相似。Objective To investigate the clinical characteristics and surgical efficacy of vestibular schwannomas(VSs)of different textures.Methods The clinical data of 116 patients with medium and large VSs admitted to the Department of Neurosurgery of Tianjin Huanhu Hospital from January 2017 to December 2021 were retrospectively analyzed.According to tumor texture,they were divided into cystic group(39 cases,33.6%)and solid group(77 cases,66.4%).The clinical characteristics,degree of tumor resection,postoperative complications,proportion of good facial nerve function(House-Brackmann grade Ⅰ and Ⅰ)and tumor recurrence rate were analyzed and compared between the two groups.In addition,clinical efficacy comparison was conducted between the cystic group and solid group in patients with Koos grade Ⅱ and grade IV,respectively.Results The cystic group had a shorter course of disease,larger maximum tumor diameter,and higher Koos grade compared to the solid group with statistically significant differences(all P<0.05).There was no statistically significant difference in the incidence of postoperative complications,follow-up time,good facial nerve function rate at discharge and last follow-up or recurrence rate between the cystic group and the solid group patients(all P>0.05).The proportion of total resection in the cystic group was lower than that in the solid group[30.8%(12/39)us.71.4%(55/77),P<0.001].In patients with Koos grade II(7 cases in the cystic group and 32 cases in the solid group)and grade IV(32 cases in the cystic group and 45 cases in the solid group),the proportion of total tumor resection in the cystic group was lower than that in the solid group(both P<0.05);there was no statistically significant difference in the incidence of postoperative complications,follow-up time,good facial nerve function at discharge and last follow-up,or recurrence rate between the cystic and solid groups(all P>0.05).Conclusions Among patients with medium and large VSs,cystic VSs have the clinical characteristics of rapid growth and

关 键 词：神经瘤 听 面神经 囊性 切除程度 

分 类 号：R739.4[医药卫生—肿瘤]