CAJ | 학술논문

目的：探讨神经电生理监测在桥小脑角肿瘤显微切除手术中的应用价值。方法选取2005‐06—2011‐12收治桥小脑角肿瘤患者84例，均采用神经电位监测下经枕下乙状窦后入路，显微镜下手术切除肿瘤，分别在术后10 d、6个月、1 a进行随访，评估患者面神经功能情况。结果84例患者肿瘤全切73例（86.9％），次全切11例（13.1％），神经解剖保留71例，保留率84.5％，无死亡及后组脑神经损伤病例。术后10 d面神经功能评级：Ⅰ级＋Ⅱ级患者31例，良好率36.9％，Ⅴ＋Ⅵ级14例（16.7％）；术后6个月：Ⅰ级＋Ⅱ级60例（71.4％），Ⅴ＋Ⅵ级8例（9.5％）；术后1 a：Ⅰ级＋Ⅱ级74例（88.1％），Ⅴ＋Ⅵ级2例（2.4％）。结论神经电生理监测有助于确定神经位置，明显提高面神经的保留率，提高患者术后生活质量，对提高手术安全性，减少术后并发症有不可低估的价值。
목적：탐토신경전생리감측재교소뇌각종류현미절제수술중적응용개치。방법선취2005‐06—2011‐12수치교소뇌각종류환자84례，균채용신경전위감측하경침하을상두후입로，현미경하수술절제종류，분별재술후10 d、6개월、1 a진행수방，평고환자면신경공능정황。결과84례환자종류전절73례（86.9％），차전절11례（13.1％），신경해부보류71례，보류솔84.5％，무사망급후조뇌신경손상병례。술후10 d면신경공능평급：Ⅰ급＋Ⅱ급환자31례，량호솔36.9％，Ⅴ＋Ⅵ급14례（16.7％）；술후6개월：Ⅰ급＋Ⅱ급60례（71.4％），Ⅴ＋Ⅵ급8례（9.5％）；술후1 a：Ⅰ급＋Ⅱ급74례（88.1％），Ⅴ＋Ⅵ급2례（2.4％）。결론신경전생리감측유조우학정신경위치，명현제고면신경적보류솔，제고환자술후생활질량，대제고수술안전성，감소술후병발증유불가저고적개치。
Objective To study the application value of neurophysiological monitoring in the cerebellopontine angle tumor micro‐resection.Methods There were 84 cases of patients with cerebellopontine angle tumor in our hospital from June 2005 to November 2010. All patients of cerebellopontine angle tumor had been monitored during the resection. All patients were fol‐lowed for 10 days ,6 months and 1 year after the operation. The facial nerve function of patients was evaluated.Results In the 84 cases of patients ,complete removal of the tumors was 73 cases (86.9% ) ,subtoal resection was 11 cases (13.1% ). The pa‐tients of the neuroanatomy retention were 71 cases and the retention rate was 84.5%. After 10 days ,the facial nerve function was valuted that 31 cases (36.9% ) with Ⅰ and Ⅱ and 14 cases(16.7% ) with Ⅴ and Ⅵ. After 6 months ,60 cases (71.4% ) with Ⅰ and Ⅱ and 8 cases (16.7% ) with Ⅴ and Ⅵ. After 1 year ,74 cases (88.1% ) with Ⅰ and Ⅱ and 2 cases (2.4% ) withⅤ and Ⅵ.Conclusion The neurophysiological monitoring is helpful to determine the neural position and obviously improve the retention rate of facial nerve. It can improve the patients’ quality of life. It has high value to the safety of the surgery and re‐duces the postoperative complications.