岩斜部脑膜瘤锁孔术后炎症因子变化及治疗效果研究

The changes of inflammatory factors and the treatment effect of petroclival meningiomas keyhole approach after operation

目的探究岩斜部脑膜瘤锁孔术后炎症因子及治疗效果。方法分析2010年1月～2013年1月27例在我院接受岩斜部脑膜瘤切除术患者的临床资料，观察组（16例）采用乙状窦后锁孔入路手术，对照组（11例）采用常规枕下乙状窦后入路手术。结果分析2010年1月~2013年1月27例在我院接受岩斜部脑膜瘤切除术患者的临床资料，观察组（16例）采用乙状窦后锁孔入路手术，对照组（11例）采用常规枕下乙状窦后入路手术。结论乙状窦后锁孔入路手术治疗效果优于常规枕下乙状窦后入路手术，具有术后炎症反应较小、患者术后恢复情况佳、复发率低等优点。

Objective To investigate the Changes of inflammatory factors and the treat- ment effect of petroclival meningiomas keyhole approach after operation. Methods The clinical data of 27 cases patients accepted the petroclival meningioma resection in our hospital were analy- zing from January 2010 to January 2013,the observation group （16 cases） were operated sigmoid sinus after keyhole approach surgery, control group （11 cases） were using conventional sub occip- ital sigmoid sinus surgery. Results After surgery, serum IL-- 6, CRP levels in Two groups showed a rising trend,24h serum TNF--a levels in the observation group were significantly high- er than the control group,the difference was statistically significant （P〈0. 05） ,but after the 24h and 48h serum TNF-α were not statistically different （P〉0.05）. In control group,the level of serum TNF-α was increased in the patients of the control group. After inter group comparison,it is found that the observation group of patients after 24h,48h TNF-α,IL-6 ,CRP level was sig- nificantly lower than that of the control group, the difference had statistical differences （P 0.05） ;KPS good rate of observation group patients after 2 weeks was significantly higher than that of the control group, the difference has statistics significance （x2 = 4. 492, P = 0. 034）. After two and a half years of follow--up,we found that GOS satisfaction rate of the observation group was significantly higher than that in the control group, and the difference is statistically significant （x2 =5. 632,P= 0. 018）;the postoperative recurrence rate in observation group was significantly lower than that of the control group＇ difference has statistical significance （1/11,9.09% vs 4 / 11,36.36% ;log--rank x2 =4. 292,P=0. 038）. Conclusion The treatment effect of sigmoid sinus after keyhole surgery is better than the conventional surgery under the sigmoid sinus,it has less inflammatory response, postoperative recovery is good,and low recurrence rate.