眶上锁孔入路及超声吸引器在鞍结节脑膜瘤手术的应用

目的 探讨眶上锁孔入路、超声吸引器在鞍结节脑膜瘤手术治疗中的应用效果。 方法 分析2014年1月至2017年1月福建医科大学附属协和医院和柳州市中医医院收治的65例鞍结节脑膜瘤的临床资料，根据手术治疗方法分为对照组与观察组。其中32例患者接受常规手术治疗为对照组，另33例患者接受眶上锁孔入路、超声吸引器治疗为观察组。比较两组患者肿瘤有效切除率、神经功能缺损程度（GCS评分）、并发症及生活质量。 结果 观察组患者肿瘤有效切除率（9667%）高于对照组（7813%）（P＜005）。两组患者神经功能缺损程度术前差异无统计学意义（P＞005），术后观察组神经功能缺损程度低于对照组（GCS评分1598±123比1259±122）（P＜005）。观察组患者并发症发生率（606%）低于对照组（2188%）（P＜005）。两组患者术前生活质量SF 36评分差异无统计学意义（P＞005），术后在生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康评分均有升高，但观察组患者术后以上各项评分均高于对照组（均P＜005）。 结论 眶上锁孔入路联合超声吸引器治疗鞍结节脑膜瘤疗效较佳，能在提高治疗效果的同时改善患者生活质量，术后并发症少，神经损伤小，值得临床推广应用。

Application of Supraorbital Keyhole Approach and Ultrasonic Aspirator in Surgical Treatment of Tuberculum Sellae Meningiomas

Abstract] Objective To investigate the application of supraorbital keyhole approach and ultrasonic aspirator in surgical treatment of tuberculum sellae meningiomas. Methods The clinical data of the tuberculum sellae meningiomas treated in our hospital from January 2014 to January 2017 in our hospital were retrospectively analyzed. Patients were divided into two groups according to different surgical methods. 32 patients in the control group received routine surgery, while 33 patients in observation group underwent supracondylar keyhole approach and ultrasonic aspirator treatment. The tumor resection effect, Glasgow Coma Scale (GCS), complications, and quality of life scores were compared between the two groups. Results The effective rate of tumor resection in the observation group was significantly higher than that in the control group (Z=-3.787, P=0.000); The GCS score had no difference before surgery (P>0.05), which was higher in the observation group than in the control group after treatment (P<0.05); The overall incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). The quality of life score of the two groups had no difference before treatment (P>0.05). After treatment, the scores of the PF, RP, P, GH, VT, SF, RE, and MH were increased, and were higher in the observation group than those in the control group (P<0.05). Conclusion The application of the supraorbital keyhole approach and ultrasonic aspirator can improve the quality of life and reduce the nerve damage with fewer complications in surgical treatment of tuberculum sellae meningiomas, which is recommended.