面神经监测在听神经瘤术中面神经保护作用研究.docVIP

面神经监测在听神经瘤术中面神经保护作用研究 　　【摘要】 目的：探讨面神经监测在听神经瘤术中面神经解剖及功能保留的应用。方法：回顾性对比分析本科室2007年1月-2012年1月普通听神经瘤手术面神经的解剖及功能保留的25例患者（未监测组）与2012年2月-2016年2月术中行监测的27例患者（监测组）的听神经瘤的临床资料。结果：术后，未监测组的肿瘤全切少于监测组，差异有统计学意义（ 字2=3.107，P=0.078）。未监测组死亡1例，监测组无死亡病例，两组比较差异无统计学意义（P0.05）。术后，监测组仅12例面神经解剖保留，少于监测组的24例，差异有统计学意义（ 字2=10.188，P=0.001）。两组术后的面神经功能分级比较，差异有统计学意义（u=482，P=0.004）。结论：听神经瘤术中面神经监测可显著提高术后面神经解剖及功能的保留率。 　　【关键词】 听神经瘤； 面神经电生理监测； 解剖及功能保留 　　【Abstract】 Objective：To explore the application of facial nerve monitoring for the facial nerve anatomy and function protection in acoustic neuromas surgery.Method：The clinical data of acoustic neuromas operation with non monitering 25 cases（non monitoring group）from January 2007 to January 2012 and 27 cases using facial nerve monitoring（monitoring group） from February 2012 to February 2016 were collected and analyzed by retrospective.Result：After operation，the total tumor resection in the non monitoring group was less than that in the monitoring group，the difference was statistically significant（ 字2=3.107，P=0.078）.There was 1 death in the non monitoring group，and there was no death in the monitoring group，there was no significant difference between the two groups（P0.05）.After the operation，only 12 cases of facial nerve were preserved in the monitoring group，less than 24 cases in the monitoring group，the difference was statistically significant（ 字2=10.188，P=0.001）.There were significant differences in facial nerve function classification between the two groups after operation（u=482，P=0.004）.Conclusion：Facial nerve electrophysiological monitoring can improve the preservation rate of facial nerve anatomy and function in acoustic neuroma operation. 　　【Key words】 Acoustic neuromas； Electrophysiological monitoring of facial nerve； Facial nerve anatomy and function preservation 　　First-author’s address：Ganzhou People’s Hospital，Ganzhou 341000，China 　　doi：10.3969/j.issn.1674-4985.2017.33.014 　　听神经瘤占颅内肿瘤的8%～10%[1]，是常见的颅内肿瘤之一，早期听神经瘤治疗完全依赖手术切除，治疗也以全切肿瘤为目标，随着显微外科