论著

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

The effect of neuroendoscopy on functional recovery and prognosis of cerebellopontine angle tumors during minimally invasive surgery

:61-64
 
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.
论著

静脉复合局部浸润麻醉在乳腺多发性肿物微创旋切术中的应用

Application of Propofol intravenous anesthesia combining with local infiltration anesthesia in minimally invasive surgery for multiple breast lumps excision

:36-38
 
目的 分析总结异丙酚静脉麻醉复合利多卡因乳腺后间隙局部浸润麻醉在乳腺多发性肿块真空辅助微创旋切术的临床应用体会。方法 通过对我院2012年3月—2015年3月380例乳腺多发性肿物在异丙酚静脉麻醉复合利多卡因乳腺后间隙局部浸润麻醉下行真空辅助微创旋切术的病例,进行回顾性综合分析。结果 手术前、中和手术后血氧饱和度无明显变化;手术中平均动脉压、心率与术前比较,差异有统计学意义(P<0.05);麻醉效果好,术后并发症少。结论 乳腺多发性肿物真空辅助微创旋切术采用异丙酚静脉麻醉复合利多卡因乳腺后间隙局部浸润麻醉,安全可行,患者依从性好、满意度和耐受度较高,临床效果满意。
Objective To investigate the applicative value of Propofol intravenous anesthesia combining with local infiltration anesthesia in vacuum assisted biopsy minimal invasive system for multiple breast lumps excision. Methods Encor minimally invasive surgery was performed under Propofol intravenous anesthesia together with local infiltration anesthesia in 380 cases with multiple breast lumps admitted to our department from March 2012 to March 2015. Anesthesia effect, SpO2, MAP and HR were analyzed retrospectively. Results All 380 patients achieved good anesthetic effect for completing multiple breast lumps excision. The postoperative complications were less. There was no obvious change of oxyhemoglobin saturation (SpO2) before, during and after the surgery period (P>0.05). The mean arterial pressure (MAP) and heart rate (HR) had statistical significance compared the surgery period with the pre-operative time (P<0.05). Conclusion Vacuum assisted biopsy minimal invasive system under Propofol intravenous anesthesia combining with local infiltration anesthesia is a safety and feasible method for multiple breast lumps excision. It has more advantages including perfect anesthetic effect, good patient compliance, higher satisfaction and higher tolerance level.
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