超声吸引器联合微型电刀用于颅底脑膜瘤手术的研究

Application of CUSA combined with miniature electric knife in the surgery of skull base meningioma

目的:探讨超声吸引器联合微型电刀在颅底脑膜瘤手术的治疗效果。方法:选取医院神经外科病区收治的125例颅底脑膜瘤患者,按照随机数表法将其分为观察组(65例)和对照组(60例),观察组使用超声吸引器联合微型电刀切除肿瘤,对照组采用普通吸引器联合弹簧剪刀切除肿瘤。比较两组患者围术期包括手术时间、平均住院天数、术中出血量及输血量情况,术中切除效果,症状好转情况,以及并发症及预后情况。结果:观察组患者与对照组相比,围手术期指标明显好转,手术时间及平均住院日明显缩短,术中出血量及输血量明显降低,差异有统计学意义(t=11.981,t=61.757,t=87.446,t=22.051;P<0.05)。两组肿瘤切除Simpson分级差异显著(Z=-6.702,P<0.05)。术后观察组患者的临床症状中肢体功能障碍、失语及癫痫改善比例较术前明显提高,对照组仅肢体功能障碍方面改善明显;观察组患者与对照组相比,术后失语及癫痫症状比较,差异有统计学意义(χ^(2)=3.766,χ^(2)=4.383;P<0.05),术后并发症发生率低于对照组(χ^(2)=6.390,P<0.05),而复发率也明显低于对照组(Z=8.036,P<0.05)。结论:超声吸引器联合微型电刀对颅底脑膜瘤患者的切除效果更好,并能促进临床症状恢复,减少疾病复发,具有临床应用价值。

Objective:To explore the effect of cavitron ultrasonic surgical aspirator(CUSA)combined with miniature electric knife on patients who undergo the surgery of skull base meningioma.Methods:125 patients with skull base meningioma admitted to the neurosurgery department of hospital were selected.They were divided into observation group(65 cases)and control group(60 cases)by random number table method.The observation group of patients were treated with CUSA combined with miniature electric knife,while the control group adopted common aspirator combined with spring scissors for resection of tumor.The perioperative conditions(duration of operation,average length of hospital stay,amount of intraoperative blood loss and blood transfusion),effect of tumor resection,improvement of symptom,complication and prognosis were compared between the two groups.Results:Compared with the control group,the indicators of perioperative period of observation group were significantly improved,and the duration of operation and the average length of hospital stay were significantly shortened,and the amount of intraoperative blood loss and blood transfusion in observation group were significantly reduced(t=11.981,t=61.757,t=87.446,t=22.051,P<0.05).There was significant difference in Simpson grade of tumor resection between the two groups(Z=-6.702,P<0.05).The improved ratios of clinical symptoms(limb dysfunction,aphasia and epilepsy)of observation group after surgery were significantly higher than those before surgery,and only the difference of the improvement of limb dysfunction of control group was significant between before and after surgery.The aphasia and epilepsy after surgery of observation group were significantly better than those of control group(χ^(2)=3.766,χ^(2)=4.383,P<0.05),and the incidence rate of postoperative complication and the recurrence rate of observation group were significantly lower than those of control group(χ^(2)=6.390,Z=8.036,P<0.05).Conclusion:The resection effect of CUSA combined with miniature electric knife is better for patients with skull base meningioma,and it can promote recovery of clinical symptom and reduce recurrence of disease,which is worthy of clinical promotion.