神经内镜辅助后颅窝显微神经外科手术治疗脑肿瘤的临床研究

Clinical study of posterior fossa microneurosurgery assisted by neuroendoscope in the treatment of brain tumors

目的探究神经内镜辅助后颅窝显微神经外科手术治疗脑肿瘤对患者炎性因子水平的影响与安全性。方法按照随机数字表法将2020年1月至6月在菏泽市立医院接受治疗的56例脑肿瘤患者分为参照组(28例,行后颅窝显微手术治疗)与试验组(28例,行神经内镜辅助颅窝显微神经外科手术治疗)。对比两组患者肿瘤切除率,术前、术后2周美国国立卫生研究院卒中量表(NIHSS)评分,白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,术前、术后3个月日常生活能力量表(ADL)评分,术后3个月恢复情况及并发症发生情况。结果试验组患者肿瘤完全切除率较参照组升高;术后2周两组患者NIHSS评分、IL-6、TNF-α均较术前下降,且试验组下降幅度大于参照组;术后3个月两组患者ADL评分均较术前上升,且试验组上升幅度大于参照组;术后3个月试验组患者病症好转率为92.86%,较参照组的71.43%提升;试验组患者并发症总发生率较对照组下降(均P<0.05)。结论神经内镜辅助后颅窝显微神经外科手术治疗脑肿瘤,可有效改善患者的神经功能,抑制炎症反应,术后肿瘤完全切除率较高,有助于改善患者的术后自主生活能力,减少术后并发症的发生。

Objective To explore the effects and safety of posterior fossa microneurosurgery assisted by neuroendoscope for brain tumors on the levels of inflammatory factors.Methods According to the random number table method;56 patients with brain tumor treated in Heze Municipal Hospital from January to June 2020 were divided into the control group(28 cases,which were received posterior fossa microsurgery)and the experimental group(28 cases,which were received posterior fossa microneurosurgery assisted by neuroendoscope).Tumor resection rates,the National Institutes of Health Stroke Scale(NIHSS)scores,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)before and 2 weeks after surgery,ability of daily living(ADL)score before and 3 months after surgery,recovery status and complications 3 months after surgery were compared between the two groups.Results The rate of complete tumor resection in the experimental group was significantly higher than that of the control group;NIHSS scores;IL-6 and TNF-α of the two groups of patients 2 weeks after surgery were lower than before surgery,and the decline in the experimental group was greater than that of the control group;the ADL scores of the two groups of patients increased 3 months after surgery,and the increase in the experimentai group was greater than that of the control group;the improvement rate of the patients in the experimental group was 92.86% 3 months after surgery which was significantly higher than 71.43% in the control group;the total incidence of complications in the experimental group was significantly lower than that of the control group(all P<0.05).Conclusion Posterior fossa microneurosurgery assisted by neuroendoscope in the treatment of brain tumors can effectively improve the neurological function of patients,inhibit the inflammatory response;and achieve a high total tumor resection rate after surgery,which is helpful to improve the patients'ability to live independently after surgery and reduce the occurrence of postoperative complications.