神经电生理监测在84例桥小脑角肿瘤显微切除术中的应用

Application of neurophysiological monitoring in 84 cases of cerebellopontine angle tumor micro-resection

目的探讨神经电生理监测在桥小脑角肿瘤显微切除手术中的应用价值。方法选取2005-06—2011-12收治桥小脑角肿瘤患者84例,均采用神经电位监测下经枕下乙状窦后入路,显微镜下手术切除肿瘤,分别在术后10d、6个月、1a进行随访,评估患者面神经功能情况。结果 84例患者肿瘤全切73例(86.9%),次全切11例(13.1%),神经解剖保留71例,保留率84.5%,无死亡及后组脑神经损伤病例。术后10d面神经功能评级:Ⅰ级+Ⅱ级患者31例,良好率36.9%,Ⅴ+Ⅵ级14例(16.7%);术后6个月:Ⅰ级+Ⅱ级60例(71.4%),Ⅴ+Ⅵ级8例(9.5%);术后1a:Ⅰ级+Ⅱ级74例(88.1%),Ⅴ+Ⅵ级2例(2.4%)。结论神经电生理监测有助于确定神经位置,明显提高面神经的保留率,提高患者术后生活质量,对提高手术安全性,减少术后并发症有不可低估的价值。

Objective To study the application value of neurophysiological monitoring in the cerebellopontine angle tumor micro‐resection.Methods There were 84 cases of patients with cerebellopontine angle tumor in our hospital from June 2005 to November 2010. All patients of cerebellopontine angle tumor had been monitored during the resection. All patients were fol‐lowed for 10 days ,6 months and 1 year after the operation. The facial nerve function of patients was evaluated.Results In the 84 cases of patients ,complete removal of the tumors was 73 cases （86.9% ） ,subtoal resection was 11 cases （13.1% ）. The pa‐tients of the neuroanatomy retention were 71 cases and the retention rate was 84.5%. After 10 days ,the facial nerve function was valuted that 31 cases （36.9% ） with Ⅰ and Ⅱ and 14 cases（16.7% ） with Ⅴ and Ⅵ. After 6 months ,60 cases （71.4% ） with Ⅰ and Ⅱ and 8 cases （16.7% ） with Ⅴ and Ⅵ. After 1 year ,74 cases （88.1% ） with Ⅰ and Ⅱ and 2 cases （2.4% ） withⅤ and Ⅵ.Conclusion The neurophysiological monitoring is helpful to determine the neural position and obviously improve the retention rate of facial nerve. It can improve the patients’ quality of life. It has high value to the safety of the surgery and re‐duces the postoperative complications.