听神经瘤显微切除术中多模式神经电生理监测的效果OA
Effect of intraoperative multimodal neurophysiological monitoring during microdissection of acoustic neuroma
目的 探究听神经瘤显微切除术中应用多模式神经电生理监测的效果.方法 回顾性选取2021-01-2025-01郴州市第一人民医院及中南大学湘雅医院收治的190例听神经瘤患者,对照组和研究组各95例,对照组行单纯显微切除术,研究组在对照组基础上结合多模式神经电生理监测,比较2组手术指标、疼痛程度、听力、面神经功能、并发症发生率、GOS评分及生活质量等.结果 研究组术中出血量、内听道后唇磨除区域及疼痛视觉模拟评分法(VAS)评分低于对照组(分别为t=4.499、30.273、44.644,P＜0.001),手术时间短于对照组(t=3.035,P=0.003),肿瘤全切率高于对照组(90.53％比75.79％,x2=7.692,P=0.021).术后1个月,研究组纯音平均听阈(PTA)低于对照组(t=9.283,P＜0.001),听力分级明显优于对照组(x2=22.741,P＜0.001).术后6个月,研究组面神经功能House-Brackmann分级显著优于对照组(x2=8.311,P=0.040).研究组并发症发生率低于对照组(3.16％比11.58％,x2=4.935,P=0.026).术后6个月,研究组GOS评分及SF-36评分均高于对照组(分别为t=6.584、8.642,P＜0.001).结论 听神经瘤显微切除术中应用多模式神经电生理监测可有效缩短手术时间,提升肿瘤全切率,保护患者听力及面神经功能,改善患者短期预后和生活质量.
Objective To investigate the effect of intraoperative application of multimodal neurophysiological monitoring during microdissection of acoustic neuroma.Methods A retrospective selection was made of 190 patients with acoustic neuroma admitted to the First People's Hospital of Chenzhou and Xiangya Hospital of Central South University from January 2021 to January 2025,with 95 cases in the control group and 95 cases in the study group.The control group underwent simple microdissection,while the study group was combined with multi-modal neurophysiological monitoring on the basis of the control group.The two groups were compared in terms of surgical indexes,pain level,hearing,facial nerve function,complication rate,Glasgow outcome scale(GOS)score and quality of life.Results Intraoperative bleeding,area of posterior labial abrasion of the internal auditory canal,and visual analogue scale(VAS)score were lower in the study group than those in the control group(t=4.499,30.273,44.644,respectively,P＜0.001),operation time was shorter than that in the control group(t=3.035,P=0.003),and the rate of complete tumour resection was higher than that in the control group(90.53％vs 75.79％,x2=7.692,P=0.021).At 1 month postoperatively,the pure tone mean hearing threshold(PTA)of the study group was lower than that of the control group(t=9.283,P＜0.001),and the audiological grading was significantly better than that of the control group(x2=22.741,P＜0.001).At 6 months postoperatively,House-Brackmann grading was significantly better in the study group than that in the control group(x2=8.311,P=0.040).The complication rate was lower in the study group than that in the control group(3.16％vs 11.58％,x2=4.935,P=0.026).At 6 months postoperatively,GOS score and SF-36 score were higher in the study group than those in the control group(t=6.584,8.642,respectively,P＜0.001).Conclusion The intraoperative application of multimodal neurophysiological monitoring during microdissection of acoustic neuroma can effectively shorten the operation time,enhance the rate of total tumour resection,protect the patients' hearing and facial nerve function,and improve the patients' short-term prognosis and quality of life.
邓陈浩;叶友忠;唐国强;袁健;李鹃;李明松
郴州市第一人民医院,湖南郴州 423000郴州市第一人民医院,湖南郴州 423000郴州市第一人民医院,湖南郴州 423000中南大学湘雅医院,湖南长沙 410028中南大学湘雅医院,湖南长沙 410028郴州市第一人民医院,湖南郴州 423000
医药卫生
听神经瘤显微切除术多模式神经电生理监测疼痛听力面神经功能
Acoustic neuromaMicrotomyMultimodal neurophysiological monitoringPain levelHearingFacial nerve function
《中国实用神经疾病杂志》 2026 (1)
26-31,6
郴州市科学技术局科技发展计划项目(编号:ZDYF2020109)
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