临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
9期
742-745
,共4页
肿瘤%岩斜区%手术入路%对比分析
腫瘤%巖斜區%手術入路%對比分析
종류%암사구%수술입로%대비분석
Tumor%The petroclival region%Operation approach%comparative analysis
目的：对比分析采用不同手术入路切除岩斜区肿瘤的临床疗效。方法选取2013年7月到2014年7月手术治疗的100例岩斜区肿瘤患者，根据患者的情况采用不同的手术入路，对患者的临床表现、特征，手术入路的方法，治疗结果以及术后临床并发症进行对比分析。结果经岩骨乙状窦前入路的全切除率、次全切除率，美国国立卫生研究院卒中量表（NIHSS）评分、神经功能缺损评分（CSS）显著好于枕下乙状窦后入路、颞下前岩骨硬膜外入路以及颞下经小脑幕入路，差异有统计学意义（ P <0.05）；经岩骨乙状窦前入路患者并发颅内感染（14.89%）和听神经麻痹（17.02%）的患者比率明显高于其他三种手术入路方式（均为0%）；经枕下乙状窦后入路患者并发皮下积液（12.50%）的患者比率明显高于其他三种手术入路方式（均为0%）；经颞下经小脑幕入路并发复视（15.38%）的患者比率明显高于其他三种手术入路方式（均为0%），差异均具有统计学意义（ P <0.05）。结论不同位置的岩斜区肿瘤选用适合的手术入路可以提高肿瘤的切除率，减少并发症的发生，有效改善患者的术后恢复程度。经岩骨乙状窦前入路是临床手术入路中临床效果最为显著的治疗手段。
目的：對比分析採用不同手術入路切除巖斜區腫瘤的臨床療效。方法選取2013年7月到2014年7月手術治療的100例巖斜區腫瘤患者，根據患者的情況採用不同的手術入路，對患者的臨床錶現、特徵，手術入路的方法，治療結果以及術後臨床併髮癥進行對比分析。結果經巖骨乙狀竇前入路的全切除率、次全切除率，美國國立衛生研究院卒中量錶（NIHSS）評分、神經功能缺損評分（CSS）顯著好于枕下乙狀竇後入路、顳下前巖骨硬膜外入路以及顳下經小腦幕入路，差異有統計學意義（ P <0.05）；經巖骨乙狀竇前入路患者併髮顱內感染（14.89%）和聽神經痳痺（17.02%）的患者比率明顯高于其他三種手術入路方式（均為0%）；經枕下乙狀竇後入路患者併髮皮下積液（12.50%）的患者比率明顯高于其他三種手術入路方式（均為0%）；經顳下經小腦幕入路併髮複視（15.38%）的患者比率明顯高于其他三種手術入路方式（均為0%），差異均具有統計學意義（ P <0.05）。結論不同位置的巖斜區腫瘤選用適閤的手術入路可以提高腫瘤的切除率，減少併髮癥的髮生，有效改善患者的術後恢複程度。經巖骨乙狀竇前入路是臨床手術入路中臨床效果最為顯著的治療手段。
목적：대비분석채용불동수술입로절제암사구종류적림상료효。방법선취2013년7월도2014년7월수술치료적100례암사구종류환자，근거환자적정황채용불동적수술입로，대환자적림상표현、특정，수술입로적방법，치료결과이급술후림상병발증진행대비분석。결과경암골을상두전입로적전절제솔、차전절제솔，미국국립위생연구원졸중량표（NIHSS）평분、신경공능결손평분（CSS）현저호우침하을상두후입로、섭하전암골경막외입로이급섭하경소뇌막입로，차이유통계학의의（ P <0.05）；경암골을상두전입로환자병발로내감염（14.89%）화은신경마비（17.02%）적환자비솔명현고우기타삼충수술입로방식（균위0%）；경침하을상두후입로환자병발피하적액（12.50%）적환자비솔명현고우기타삼충수술입로방식（균위0%）；경섭하경소뇌막입로병발복시（15.38%）적환자비솔명현고우기타삼충수술입로방식（균위0%），차이균구유통계학의의（ P <0.05）。결론불동위치적암사구종류선용괄합적수술입로가이제고종류적절제솔，감소병발증적발생，유효개선환자적술후회복정도。경암골을상두전입로시림상수술입로중림상효과최위현저적치료수단。
Objective Comparative analysis of resection of petrosaclival tumors with different operation approach clinical effect. Methods One hundred cases of tumor patients received operation treatment in our hospital from July 2013 to July 2014 were included into this study. Ac-cording to the condition of patients,all these patients were given different operation approach,compare and analyze the clinical manifestation, characteristics of the patients,methods of operation approach,treatment outcome and postoperative complications. Results The rate of total resec-tion,subtotal resection rate,NIHSS score,CSS score of trans - petrosal presigmoid approach was significantly better than the suboccipital retrosig-moid approach,subtemporal anterior petrous bone hardmembrane outer approach and subtemporal transtentorial approach. The difference was sta-tistically significant( P < 0. 05). Trans - petrosal presigmoid approach patients complicated with intracranial infection(14. 89% )and auditory nerve paralysis(17. 02% ),which were significantly higher than the proportion of other three kinds of operation ways(both 0% ). The subcutane-ous effusion rate in via suboccipital retrosigmoid approach patients was 12. 50% ,which was significantly higher than the proportion of other three kinds of operation approach(0% ). The subtemporal transtentorial approach to concurrent diplopia(15. 38% )was significantly higher than the proportion of other three kinds of operation ways(0). The difference was statistically significant( P < 0. 05). Conclusion The different location of the petroclival region tumor resection rate can be selected to improve the fit of the approach of operation,reduce the incidence of complications, and improve the degree of recovery of patients after surgery. Trans - petrosal presigmoid approach is the most significant clinical operative treatment effect in the road,and has important value in clinical application.
