摘要
目的探究术前弥散张量成像(DTI)重建联合术中面听神经电生理监测对听神经瘤术后面神经的保护作用。方法收集2016年7月—2021年10月南京医科大学附属苏州医院收治的82例听神经瘤患者的病历资料进行回顾性分析,根据治疗方案将其分为对照组和研究组,每组41例。对照组术前采用磁共振成像(MRI)平扫及增强扫描;研究组在对照组基础上联合DTI面神经重建。比较两组患者肿瘤和面神经空间位置、面神经走行判定准确率、手术时间、术中出血量及手术切除情况,记录两组患者术后并发症发生情况。术后3个月随访,比较两组患者的面神经功能及患侧术后听力水平。结果两组患者肿瘤和面神经空间位置比较,差异无统计学意义(P>0.05)。两组患者术前面神经走行判定准确率比较,差异有统计学意义(P<0.05),研究组高于对照组。两组患者术中出血量、手术时间比较,差异有统计学意义(P<0.05),研究组出血量少于对照组,手术时间短于对照组,两组患者手术切除情况比较,差异无统计学意义(P>0.05)。术前两组患者面神经功能等级比较,差异无统计学意义(P>0.05),术后研究组面神经功能优于对照组(P<0.05)。两组患者术前和术后听力水平比较,差异无统计学意义(P>0.05)。两组患者术后并发症发生率比较,差异无统计学意义(P<0.05)。结论术前DTI重建联合术中面听神经电生理监测应用于听神经瘤切除术,有助于提高术前对面神经定位的精准度,减少术中出血量,缩短手术时间,降低面神经功能损伤风险。
Objective To explore the neuroprotective effect of preoperative diffusion tensor imaging(DTI)reconstruction combined with intraoperative electrophysiological monitoring of facial auditory nerve on acoustic neuroma.Methods The medical records of 82 patients with acoustic neuroma treated in Suzhou hospital from July 2016 to October 2021 were selected and analyzed retrospectively.They were divided into study group and control group according to the treatment scheme.The control group(41 cases)underwent plain and enhanced magnetic resonance imaging(MRI)before operation,and the study group(41 cases)combined with DTI facial nerve reconstruction on the basis of the control group.The spatial position of tumor and facial nerve,the accuracy of facial nerve routing,the length of operation,the amount of intraoperative bleeding and surgical resection were compared between the two groups,and the postoperative complications of the two groups were recorded.The facial nerve function and postoperative hearing level of the affected side were compared between the two groups.Results The accuracy of preoperative nerve course detection in the study group was compared by χ^(2)-test,the difference was statistically significant(P<0.05),and the study group was higher than the control group.There was no significant difference between the two groups in the spatial relationship between facial nerve and tumor(P>0.05).The amount of intraoperative bleeding and the length of operation in the study group were significantly different by t-test(P<0.05),which was less in the study group than in the control group.There was no significant difference between the two groups byχ2-test(P>0.05).There was no significant difference in the functional grade of facial nerve between the two groups before operation by rank sum test(P>0.05).The rank sum test showed that the facial nerve function of the study group was better than that of the control group(P<0.05).After rank sum test,there was no significant difference between the two groups(P>0.05).There was no si
作者
徐力
殷义明
柳荫
陈军
陶晓旸
罗成
Li Xu;Yi-ming Yin;Yin Liu;Jun Chen;Xiao-yang Tao;Cheng Luo(Department of Neurosurgery,Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou,Jiangsu 215008,China)
出处
《中国现代医学杂志》
CAS
北大核心
2022年第17期8-13,共6页
China Journal of Modern Medicine
基金
江苏省自然科学基金(No:BK20191172)。
关键词
听神经瘤
弥散张量成像
面听神经电生理监测
面神经功能
neuroma,acoustic
diffusion tensor imaging
electrophysiological monitoring of facial auditory nerve
facial nerve function
