乙状窦后入路与远外侧入路治疗岩斜区脑膜瘤的效果比较

Comparison of the effectiveness of retrosigmoid approach and distal lateral approach in the treatment of petroclival meningioma

目的探讨乙状窦后入路与远外侧入路治疗岩斜区脑膜瘤的效果。方法选取2016年10月至2019年9月间陕西省神木市医院收治的行手术治疗的60例岩斜区脑膜瘤患者,根据手术入路方式不同分为观察组和对照组,每组30例。对照组患者行远外侧入路肿瘤切除术,观察组患者行乙状窦后入路肿瘤切除术,比较两组患者肿瘤切除程度、神经功能缺损程度、卡氏功能状态评分及并发症发生情况。结果观察组患者全切/近全切率高于对照组患者,次全切率低于对照组患者,差异均有统计学意义(均P<0.05)。术前,两组患者功能状态和生活质量评分比较,差异无统计学意义(P>0.05);术后3个月,两组患者的功能状态评分均降低,生活质量评分均升高,且观察组均优于对照组,差异均有统计学意义(均P<0.05)。两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论乙状窦后入路岩斜区脑膜瘤切除术的根治性切除率高,术后患者神经功能及生活质量均较好,值得临床借鉴。

Objective To compare the effectiveness of retrosigmoid approach and distal lateral approach in the treatment of petroclival meningioma.Methods Sixty patients with petroclival meningioma who underwent surgical treatment at Shenmu Hospital were selected from October 2016 to September 2019.They were divided into two groups according to the different surgical approaches with 30 patients each.In the observation group,retrosigmoid approach was applied for tumor resection,and in the control group,distal lateral approach was applied for tumor resection.The tumor resection degree,nervous system function disturbances,Karnofsky performance status(KPS)scores and complications were compared between the two groups.Results The total/near-total resection rate was higher in the observation group than in the control group(P<0.05),and the sub-total resection rate was lower in the observation group than in the control group(P<0.05).There was no significant difference in function and quality of life scores between the two groups before the operation(P>0.05).At 3 months after the operation,function scores decreased and quality of life scores increased in the two groups with the observation group better than the control group(all P<0.05).There was no significant difference in the incidence of complication between the two groups(P>0.05).Conclusion The radical resection rate was high in patients undergoing resection of petroclival meningioma through retrosigmoid approach with good postoperative function and quality of life,which is wor-thy of clinical reference.