摘要
目的探讨神经内镜在颅底显微神经外科手术治疗脑肿瘤中的辅助作用。方法回顾性选取2017年8月至2019年8月丹东市第一医院收治的脑肿瘤患者90例,按照治疗方法分为两组:对照组和研究组,每组各45例。对照组患者采用颅底显微神经外科手术治疗,研究组患者采用神经内镜辅助颅底显微神经外科手术治疗。统计分析两组患者的切除情况、术后情况、术后并发症、脑神经损害、复发情况。结果研究组患者的全切除率[88.9%(40/45)]显著高于对照组[64.4%(29/45)],大部分切除率[11.1%(5/45)]显著低于对照组[35.6%(16/45)],差异均具有统计学意义(P<0.05)。研究组患者的术后恢复良好率[46.7%(21/45)]、中度残疾率[46.7%(21/45)]均显著高于对照组[33.3%(15/45)、37.8%(17/45)],严重残疾率[4.4%(2/45)]、植物状态率[2.2%(1/45)]、死亡率(0.0)均显著低于对照组[13.3%(6/45)、8.9%(4/45)、6.7%(3/45)],差异均具有统计学意义(P<0.05)。研究组患者的脑神经损害率[4.4%(2/45)]、复发率[2.2%(1/45)]均显著低于对照组[11.1%(5/45)、13.3%(6/45)],差异具有统计学意义(P<0.05),但两组患者的术后并发症发生率比较(11.1%vs.15.6%),差异无统计学意义(P>0.05)。结论神经内镜在颅底显微神经外科手术治疗脑肿瘤中能够有效提升患者的肿瘤全切除率、术后恢复良好率、重度残疾率,降低患者的严重残疾率、植物状态率、死亡率、脑神经损害率和复发率,且不会增加患者的术后并发症,值得临床推广应用。
Objective To explore the auxiliary effect of neuroendoscopy in the treatment of brain tumors.Methods 90 cases of patients with brain tumor in Dandong First Hospital from August 2017 to August 2019 were retrospectively selected,according to the treatment method,they were divided into two groups:the control group and the study group,45 cases in each group.The patients in the control group were treated with cranial base microsurgery,while the patients in the study group were treated with neuroendoscope-assisted cranial base microsurgery.The resections,postoperative situations,postoperative complications,brain and nerve damage,recurrences of the two groups were statistically analyzed.Results The total resection rate of the study group[88.9%(40/45)]was significantly higher than that of the control group[64.4%(29/45)],the majority resection rate[11.1%(5/45)]was significantly lower than that of the control group[35.6%(16/45)],the differences were statistically significant(P<0.05).The recovery rate[46.7%(21/45)],moderate disability rate[46.7%(21/45)]of the study group were significantly higher than those of the control group[33.3%(15/45)and 37.8%(17/45)],the severe disability rate[4.4%(2/45)],vegetative state rate[2.2%(1/45)],mortality rate(0.0)of the study group were significantly lower than those of the control group[13.3%(6/45),8.9%(4/45)and 6.7%(3/45)],the differences were statistically significant(P<0.05).The rate of brain damage[4.4%(2/45)]and recurrence[2.2%(1/45)]of the study group were significantly lower than those of the control group[11.1%(5/45)and 13.3%(6/45)],the differences were statistically significant(P<0.05),but the difference of incidence of postoperative complications between the two groups was not significant(P>0.05).Conclusion Neuroendoscopy can effectively improve the total tumor resection rate,postoperative recovery rate and severe disability rate,reduce the severe disability rate,vegetative state rate,mortality,brain and nerve damage rate and recurrence rate,and will not increase the postoperative complications of patients in the treatment of brain tumors in skull base microsurgery.It is worth of clinical promotion.
作者
宁宇
代志安
张伟
NING Yu;DAI Zhi-an;ZHANG Wei(Department of Neurosurgery,Dandong First Hospital,Dandong Liaoning 118000,China)
出处
《临床和实验医学杂志》
2020年第5期525-528,共4页
Journal of Clinical and Experimental Medicine
基金
辽宁省自然科学基金(编号:20170540935).
