坐位乙状窦后入路切除青少年听神经瘤疗效的影响因素  

Logistic regression analysis of factors influencing the efficacy of resection of adolescent acoustic neuromas through a retrosigmoid approach in sitting position

作　　者：吕晓扬 熊彬 张晴[1] LV Xiaoyang;XIONG Bin;ZHANG Qing(Department of Neurosurgery,Zhongnan Hospital of Wuhan University,Hubei,Wuhan 430000,China)

机构地区：[1]武汉大学中南医院神经外科,武汉市430000

出　　处：《河北医药》2024年第20期3132-3134,3138,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：目的基于logistic回归模型分析坐位乙状窦后入路切除青少年听神经瘤疗效的影响因素。方法纳入2020年6月至2023年9月接受坐位乙状窦后入路切除治疗的96例青少年听神经瘤患者作为研究对象。术后均进行为期3个月的随访,根据疗效分为有效组和无效组,并收集对比2组的一般资料、疾病资料以及手术资料,基于logistic回归模型分析青少年听神经瘤显微手术疗效的影响因素。结果基于logistic回归模型分析瘤体类型为囊性、瘤体直径>15 mm、瘤体位置为桥小脑角池、瘤体位置为脑干、术前的HB面神经分级≥Ⅳ级、术前AA0-HNS听力分级为C级、术前AA0-HNS听力分级为D级以及术后发生并发症属于影响坐位乙状窦后入路切除治疗青少年听神经瘤疗效的危险因素(OR>1,P<0.05),瘤体无周边水肿不属于影响青少年听神经瘤显微手术疗效的因素(P>0.05)。结论坐位乙状窦后入路切除治疗青少年听神经瘤显微手术疗效主要受类型、直径、位置以及术前面神经和听力障碍等因素的影响,同时术后并发症的发生风险也会对其的手术疗效造成不良影响。Objective To analyze factors influencing the efficacy of resection of adolescent acoustic neuromas through a retrosigmoid approach in sitting position.Methods Ninety-six patients with adolescent acoustic neuroma who were treated with resection through a retrosigmoid approach in sitting position in our hospital from June 2020 to September 2023 were included as the study subjects,and all of them were followed up for a period of 3 months after the operation.They were divided into effective and ineffective groups according to the efficacy.General data,clinical data,and surgical data were collected and compared,and the influencing factors of the efficacy of microsurgery on adolescent acoustic neuroma were analyzed based on a logistic regression model.Results Based on logistic regression,the tumor type of cystic,tumor diameter>15mm,tumor location on the pontine cerebellar angle pool and on the brainstem,preoperative HB facet neurological classification≥GradeⅣ,preoperative AAO-HNS hearing classification with Grade C,preoperative AAO-HNS hearing classification with Grade D,and the occurrence of postoperative complications were risk factors affecting the efficacy of the resection of adolescent acoustic neuromas through a retrosigmoid approach in sitting position(OR>1,P<005).The absence of peripheral edema of the tumor was not a risk factor affecting the efficacy(P>0.05).Conclusion The efficacy of resection through a retrosigmoid approach in sitting position on adolescent acoustic neuromas is mainly influenced by the type,diameter,and location of tumors,as well as by the preoperative nerve and hearing deficits.The risk of postoperative complications also adversely affects their surgical efficacy.

关 键 词：青少年 听神经瘤 坐位乙状窦后入路切除 疗效 logistic回归模型 影响因素 

分 类 号：R739.43[医药卫生—肿瘤]