听神经鞘瘤切除术术中体位与术后并发症相关性分析（附90例报告）

目的探讨听神经鞘瘤经枕下乙状窦后入路肿瘤切除术中体位与术后并发症的相关性。方法对2004年至2007年收治的90例听神经鞘瘤病人，应用显微外科技术在显微镜下行枕下乙状窦后入路肿瘤切除术，术中病人体位取坐位58例，侧卧位32例，回顾性分析术后一系列并发症的发生与术中体位的关系。结果术后出现颅内血肿5例，其中术中采取坐位者4例（6．90％），侧卧位者1例（3．12％）；术后出现颅内积气47例，其中坐位者38例（65．52％），侧卧位者9例（28．12％），经统计学分析，采取两种不同体位手术的病人颅内积气发生率差异显著（P〈0.05）。结论侧卧位下较坐位下行枕下乙状窦后入路听神经鞘瘤切除术能更有效降低听神经鞘瘤术后颅内积气的发生率。

Analysis of Correlativity between Patients" Posture during Resection of Tumors and Postoperative Complications in Patients with Aeonstic Neurilemomas

Objective To explore the correlativity between patients' posture during resection of tumors through suboccipital retrosigmoid approach and postoperative complications in the patients with acoustic neurilemomas. Methods The clinical data of 90 patients with acoustic neurilemomas, who underwent microsurgery through suboccipital retrosigmoid approach in Union Hospital from 2004 to 2007, were collected and analyzed retrospectively. Results Of 90 patients, 58 adopted sitting posture and 32 adopted lying posture on their sides during the microsurgery for the tumors. In the sitting posture group the intracranial hematomas occurred in 4 patients (6.90%, 4/58) and intracranial pneumatocaele in 38 patients (65.52%, 38/58) after the operation. In the lying posture group the intracranial hematoma occurred in 1 patients (3.12%, 1/32) and intracranial pneumatocaele in 9 patients (28.12%, 9/32) after the operation. There were significant difference in the occurrence rate of intracranial pneumatocele between both the groups (P<0.05). Conclusions The patient's lying posture on his side during microsurgery through suboccipital reterosigmoid approach can reduce the probability of postoperative intracranial pneumatocele compared to sitting posture in the patients with acoustic neurilenomas.