桥小脑角肿瘤微创切除术中应用神经内镜对其功能恢复及预后的影响

来源期刊：广州医药 | 61-64 发布时间：2023-07-12 收稿时间：2025/11/13 18:34:26 阅读量：31

作者：: 廖佳奇,

许金仙,

叶新运,

温小华,

关键词：: 桥小脑角肿瘤微创切除术神经内镜神经功能预后; minimally invasive resection of tumors in cerebellopontine angle neuroendoscope neural function prognosis

DOI：: 10.3969/j.issn.1000-8535.2023.05.010

收稿时间：: 2022-07-22
修订日期：
接收日期：
引用总数：: 2

目的探讨桥小脑角肿瘤微创切除术中应用神经内镜对其功能恢复及预后的影响,以便临床寻找出更有效的治疗方案,进而改善患者预后。方法本次研究对象为赣州市人民医院2017年6月—2022年1月收治的82例桥小脑角肿瘤患者,用随机数字表法将其分为对照组（41例）和实验组（41例）。对照组患者给予常规显微手术治疗,实验组患者给予神经内镜辅助常规显微手术治疗,2组患者均于术后观察8周。比较2组患者肿瘤全切率,手术时间、住院时间及住院费用,术前及术后2、4、8周格拉斯哥预后量表（GOS）评分,以及术后8周内并发症发生情况。结果肿瘤全切率：实验组患者术后8周（90.24%）与对照组（73.17%）相比,处于更高水平;手术时间、住院时间：实验组患者与对照组相比,处于更短水平;GOS评分：术前至术后2周,2组患者评分均呈下降趋势,术后2周至8周,2组患者评分呈升高趋势,其中实验组术后2、4、8周与对照组相比,处于更高水平,差异有统计学意义（P<0.05）;并发症总发生率：术后8周内,实验组患者（4.88%）与对照组（17.07%）相比,差异无统计学意义（P>0.05）。结论桥小脑角肿瘤微创切除术中应用神经内镜,可有效缓解患者的临床症状,优化手术相关指标,减轻神经功能受损,提高肿瘤全切率,改善预后,且安全性高。

Objective To investigate the effect of neuroendoscope on functional recovery and prognosis of patients with cerebellopontine angle tumor after microinvasive resection,so as to find out more effective treatment and improve the prognosis of patients．Methods The subjects were 82 patients with cerebellopontine angle tumors admitted to Ganzhou People's Hospital from June 2017 to January 2022．They were divided into control group（n = 41）and experimental group（n = 41）by random number table method．Patients in the control group were treated with conventional microsurgery,while patients in the experimental group were treated with neuroendoscope assisted conventional microsurgery．All patients were observed for 8 weeks after operation．The total tumor resection rate,operation time,hospitalization time,hospitalization expense,Glasgow Outcome Scale（GOS）score before and 2,4,8 weeks after operation,and complications within 8 weeks after operation were compared between the two groups．Results Compared with the control group（73.17%）,the patients in the experimental group had a higher resection removal rate of tumor after 8 weeks of operation（90.24%）．Patients in the experimental group had a shorter operation time and hospital stay than those in the control group．From pre-operation to 2 weeks after operation,the GOS scores of patients in both groups showed a downward trend,and from 2 weeks to 8 weeks after operation,the scores of patients in both groups showed an upward trend,and the patients in the experimental group were at a higher level than those in the control group at 2,4,8 weeks after operation,the difference were statistically significant（P < 0.05）．Within 8 weeks after surgery,there was no significant difference in total incidence of complications between the experimental group（4.88%）and the control group（17.07%,P > 0.05）．Conclusions The application of neuroendoscope in the minimally invasive surgery of cerebellopontine angle tumor can effectively relieve the clinical symptoms of patients,optimize the operation-related indexes,reduce the damage of nerve function,increase the total resection rate of tumor,improve the prognosis,and with high safety．

1、陈晨,张作慧,苗发安,等.神经内镜辅助显微手术治疗桥小脑角胆脂瘤[J].神经疾病与精神卫生,2019,19(10):936-938.

2、黄国栋,那鹏,徐湘平,等.神经内镜技术在桥小脑角区部分脑神经疾病中的临床应用[J].中国微侵袭神经外科杂志,2020,25(12):700-704.

3、张旭,田聪,王万洲,等.神经内镜在显微神经外科桥小脑角区胆脂瘤术中的应用[J].中华医学杂志,2022,102(13):965-968.

4、方水桥,赖勇,陈涛,等.神经内镜辅助后颅窝显微神经外科手术治疗桥小脑角区肿瘤的效果[J].中外医学研究,2020,18(9):140-141.

5、张道宝,朱晓丹,万晓强,等.神经内镜辅助技术在显微手术切除桥小脑角区肿瘤中的应用[J].中国临床神经外科杂志,2017,22(2):103-104.

6、王新厂,王向阳,韩冰.面神经电生理监测降低桥小脑角肿瘤患者术后并发症的临床观察[J].山西卫生健康职业学院学报,2021,31(2):34-36.

7、王国文,贺艳阳,王博,等.3D打印技术联合术中电生理监测在桥脑小脑角肿瘤切除中的应用价值分析[J].中华神经医学杂志,2021,20(7):700-704.

8、王亚飞,霍龙伟,郑虎林,等.显微外科手术对颅内动脉瘤患者脑脊液IL-1、IL-6、ET-1、TNF-α和GOS评分的影响[J].现代生物医学进展,2018,18(21):4126-4129,4147.

9、张永红,郑茂华.神经外科常见疾病诊治指南及专家共识[M].兰州:兰州大学出版社,2016:56-58.

10、王超. 显微手术结合神经内镜治疗囊性脑肿瘤的可行性研究[J].实用临床医药杂志,2020,24(5):18-20.

11、朱伟玲,谢玉珍,胡素芬,等.术侧上肢抱枕位对桥小脑角区肿瘤切除术患者血流动力学和安全性的影响[J].中国实用护理杂志,2021,37(1):1103-1105.

12、 HIRUTA R,SATO T,ITAKURA T,et al.Intraoperative transcranial facial motor evoked potential monitoring in surgery of cerebellopontine angle tumors predicts early and late postoperative facial nerve function[J].Clin Neurophysiol,2021,132(4):864-871.

1、束金华. 神经内镜辅助显微手术治疗桥小脑角区肿瘤患者对肿瘤全切率的影响[J]. 医师在线,2024,14(6):33-35. DOI:10.3969/j.issn.2095-7165.2024.06.010.

2、黄晓烨,高琳,陈珊.脑肿瘤患者神经内镜辅助显微手术治疗的效果分析[J].中国医疗器械信息,2025,31(22):71-74.DOI:10.15971/j.cnki.cmdi.2025.22.023.