听神经瘤术后面神经功能损伤危险因素分析

目的分析影响听神经瘤患者术后短期及长期面神经功能的危险因素。 方法回顾性分析厦门大学附属第一医院神经外科自2015年1月至2018年6月收治的62例听神经瘤患者的临床资料。于术后7 d及术后6个月对所有患者的面神经功能进行评估。收集可能与患者术后早期及长期面神经功能障碍存在相关性的因素，采用Logistic单因素与多因素回归对相关因素与患者术后短期及长期面神经功能的关系进行分析。 结果术后7 d，21例（33.9%）患者面神经功能正常，41例（66.1%）患者出现面神经功能损伤；术后6个月，49例（79.0%）患者面神经功能为正常，13例（21.0%）患者面神经功能损伤。Logistic单因素回归分析结果显示：肿瘤最大直径越大、肿瘤与面神经黏连越紧密，患者术后7 d发生面神经功能损伤的可能性越大（P=0.002、0.002）；术前临床症状持续时间为患者术后6个月面神经功能障碍的危险因素（P=0.035）。Logistic多因素回归分析结果显示：肿瘤与面神经的黏连程度、肿瘤最大直径为患者术后7 d面神经功能障碍的独立危险因素（P=0.003、0.014）；术前临床症状持续时间、肿瘤最大直径为患者术后6个月面神经功能障碍的独立危险因素（P=0.010、0.030）。 结论肿瘤与面神经的黏连越紧密、肿瘤最大直径越大，患者术后7 d发生面神经功能损伤的可能性越大。患者术前临床症状持续时间越长、肿瘤最大直径越大，术后6个月发生面神经功能损伤的可能性越大。

Analysis of risk factors of nerve function injury after acoustic neuroma surgery

ObjectiveTo analyze risk factors for short-term and long-term facial nerve function after acoustic neuroma surgery. MethodsSixty-two patients with acoustic neuroma admitted to Neurosurgery Department of the First Affiliated Hospital of Xiamen University from January 2015 to June 2018 were retrospectively analyzed. The facial nerve function of all patients was evaluated at 7 d and 6 months after surgery. The risk factors that may be related to the short-term and long-term facial nerve dysfunction were collected. The relationship between the related factors and the short-term and long-term facial nerve function was analyzed by Logistic regression. ResultsSeven days after surgery, 21 patients (33.9%) had normal facial nerve function, 41 patients (66.1%) had facial nerve function impairment; 6 months after surgery, 49 patients (79.0%) had normal facial nerve function, and 13 patients (21.0%) had facial nerve function impairment. Logistic univariate regression analysis showed that the larger the maximum diameter of the tumor and the tighter adhesion between tumor and facial nerve, the greater the possibility of facial nerve function nerve injury occurred 7 d after surgery (P=0.002, 0.002); the duration of clinical symptoms before surgery was the risk factor of facial nerve dysfunction 6 months after surgery (P=0.035). Logistic multivariate regression analysis showed that the degree of adhesion between the tumor and the facial nerve and the maximum tumor diameter were the independent risk factors for facial nerve dysfunction 7 d after surgery (P=0.003, 0.014); the duration of clinical symptoms before surgery and the maximum diameter of tumor were the independent risk factors of facial nerve dysfunction 6 months after surgery (P=0.010, 0.030). ConclusionThe tighter the adhesion between the tumor and the facial nerve and the larger the maximum diameter of the tumor, the greater the possibility of facial nerve function injury occurred 7 d after surgery. The longer the duration of clinical symptoms and the larger the maximum diameter of tumor, the greater the possibility of facial nerve injury 6 months after surgery.