翼点入路与额下入路切除鞍结节脑膜瘤手术效果对比研究(1)
[摘要] 目的 观察并比较鞍结节脑膜瘤临床治疗中采用翼点入路和额下入路的应用效果。方法 方便选取该院于2016年1月—2018年6月期间收治的61例鞍结节脑膜瘤患者为研究对象，按照患者入院时间与个人意愿，分为观察组(31例)、对照组(30例)，其中观察组患者的手术方式为额下入路，对照组患者的手术方式为翼点入路，观察并比较两组患者的临床治疗效果。 结果 观察组患者的肿瘤全切除率为87.10%，对照组患者的肿瘤全切除率为60.00%；两组数据进行对比，差异有统计学意义(χ2=5.785 2，P=0.016 1<0.05)；此外，观察组患者的视力改善率为83.87%，并发症发生率为16.12%；对照组患者的视力改善率为80.00%，并发症发生率为20.00%；相应数据值较为接近，即组间差异无统计学意义(χ2=2.977 1、0.154 6，P=0.084 4、0.694 2，P>0.05)。 结论 相对比翼点入路而言，额下入路治疗鞍结节脑膜瘤效果更为显著，而且不会给患者术后视力的改善造成不良干扰，此外，并发症发生率也在合理范围内，值得临床普及使用。
[关键词] 鞍结节脑膜瘤；翼点入路；额下入路；应用效果
[中圖分类号] R616 [文献标识码] A [文章编号] 1674-0742(2018)11(a)-0083-03
[Abstract] Objective To observe and compare the application of pterional approach and subfrontal approach in the clinical treatment of saddle nodule meningiomas. Methods 61 patients with saddle nodule meningiomas admitted to the hospital from January 2016 to June 2018 were enrolled conveniently in the study. According to the patient's admission time and personal wishes， they were divided into observation group (31 cases) and control group (30 cases). For example， the surgical method of the patients in the observation group was the subfrontal approach， and the surgical procedure of the control group was the pterional approach. The clinical treatment effects of the two groups were observed and compared. Results The total tumor resection rate was 87.10% in the observation group and 60.00% in the control group. The data of the two groups were compared， which was statistically significant(χ2=5.785 2， P=0.016 1<0.05). In addition， the observation group patient's visual acuity improvement rate was 83.87%， and the complication rate was 16.12%. The control group's visual acuity improvement rate was 80.00%， and the complication rate was 20.00%. The corresponding data values were close， that is， the difference between groups was small(χ2=2.977 1，0.154 6， P=0.084 4，0.694 2). The statistical significance was not established. Conclusion Compared with the pterional approach， the subfrontal approach for the treatment of saddle nodule meningioma is more effective， and it will not cause adverse interference to the improvement of postoperative visual acuity. In addition， the incidence of complications is within a reasonable range. It is worthy of clinical use.
[Key words] Saddle nodule meningioma； Pterional approach； Forehead approach； Application effect
鞍结节脑膜瘤作为颅内脑膜瘤的一种，相对而言，具有较高的临床发生率，据有关资料统计，颅内脑膜瘤发生总数中，鞍结节脑膜瘤所占比约为4%～10%[1]。该病症早期发作时呈现的症状多以视力障碍为主，临床治疗普遍采取手术切除法，但由于该病症的病灶位于中颅窝底，周围存在重要血管结构以及神经系统，如果瘤体较大，还会给血管、神经、组织造成物理压迫，手术治疗面临着巨大的风险，且患者术后出现并发症的可能性较大[2-4]。因此，为了探索临床最佳入路方式，在保证手术效果的同时，优化患者的预后质量。以该院于2016年1月—2018年6月期间收治的61例鞍结节脑膜瘤患者为研究对象，现报道如下。, 百拇医药(林茂晖 林健 刘水源)
[关键词] 鞍结节脑膜瘤；翼点入路；额下入路；应用效果
[中圖分类号] R616 [文献标识码] A [文章编号] 1674-0742(2018)11(a)-0083-03
[Abstract] Objective To observe and compare the application of pterional approach and subfrontal approach in the clinical treatment of saddle nodule meningiomas. Methods 61 patients with saddle nodule meningiomas admitted to the hospital from January 2016 to June 2018 were enrolled conveniently in the study. According to the patient's admission time and personal wishes， they were divided into observation group (31 cases) and control group (30 cases). For example， the surgical method of the patients in the observation group was the subfrontal approach， and the surgical procedure of the control group was the pterional approach. The clinical treatment effects of the two groups were observed and compared. Results The total tumor resection rate was 87.10% in the observation group and 60.00% in the control group. The data of the two groups were compared， which was statistically significant(χ2=5.785 2， P=0.016 1<0.05). In addition， the observation group patient's visual acuity improvement rate was 83.87%， and the complication rate was 16.12%. The control group's visual acuity improvement rate was 80.00%， and the complication rate was 20.00%. The corresponding data values were close， that is， the difference between groups was small(χ2=2.977 1，0.154 6， P=0.084 4，0.694 2). The statistical significance was not established. Conclusion Compared with the pterional approach， the subfrontal approach for the treatment of saddle nodule meningioma is more effective， and it will not cause adverse interference to the improvement of postoperative visual acuity. In addition， the incidence of complications is within a reasonable range. It is worthy of clinical use.
[Key words] Saddle nodule meningioma； Pterional approach； Forehead approach； Application effect
鞍结节脑膜瘤作为颅内脑膜瘤的一种，相对而言，具有较高的临床发生率，据有关资料统计，颅内脑膜瘤发生总数中，鞍结节脑膜瘤所占比约为4%～10%[1]。该病症早期发作时呈现的症状多以视力障碍为主，临床治疗普遍采取手术切除法，但由于该病症的病灶位于中颅窝底，周围存在重要血管结构以及神经系统，如果瘤体较大，还会给血管、神经、组织造成物理压迫，手术治疗面临着巨大的风险，且患者术后出现并发症的可能性较大[2-4]。因此，为了探索临床最佳入路方式，在保证手术效果的同时，优化患者的预后质量。以该院于2016年1月—2018年6月期间收治的61例鞍结节脑膜瘤患者为研究对象，现报道如下。, 百拇医药(林茂晖 林健 刘水源)