[1]党连锋,杨 春.术前栓塞联合经对侧纵裂入路术治疗巨大镰窦旁脑膜瘤疗效研究[J].陕西医学杂志,2022,51(8):982-985,1021.[doi:DOI:10.3969/j.issn.1000-7377.2022.08.018]
 DANG Lianfeng,YANG Chun.Efficacy of preoperative embolization combined with trans-contralateral longitudinal fissure approach sugery in treatment of giant paranasal falcate meningioma[J].,2022,51(8):982-985,1021.[doi:DOI:10.3969/j.issn.1000-7377.2022.08.018]
点击复制

术前栓塞联合经对侧纵裂入路术治疗巨大镰窦旁脑膜瘤疗效研究
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年8期
页码:
982-985,1021
栏目:
临床研究
出版日期:
2022-08-05

文章信息/Info

Title:
Efficacy of preoperative embolization combined with trans-contralateral longitudinal fissure approach sugery in treatment of giant paranasal falcate meningioma
作者:
党连锋1杨 春2
(1.陕西省核工业二一五医院神经外科,陕西 咸阳 712000; 2.安康市人民医院神经外科,陕西 安康 725000)
Author(s):
DANG LianfengYANG Chun
(Department of Neurosurgery,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China)
关键词:
巨大镰窦旁脑膜瘤 术前栓塞 经对侧纵裂入路手术 炎症因子 不良反应 MRS评分 NIHSS评分
Keywords:
Giant paranasal falcate meningioma Preoperative embolization Trans-contralateral longitudinal fissure approach sugery Inflammatory factor Adverse reactions MRS score NIHSS score
分类号:
R 739.45
DOI:
DOI:10.3969/j.issn.1000-7377.2022.08.018
文献标志码:
A
摘要:
的:探究术前栓塞联合经对侧纵裂入路术应用于巨大镰窦旁脑膜瘤的治疗效果。方法:60例巨大镰窦旁脑膜瘤患者依据手术方式的不同分为观察组(n=30)和对照组(n=30)。观察组采用术前栓塞联合经对侧纵裂入路术治疗,对照组采用常规入路术治疗,对比两组患者手术相关指标、手术前后C反应蛋白(CRP)、血沉(ESR)、白细胞计数(WBC)及相关炎症因子变化水平、不良反应发生率以及远期MRS评分与NIHSS评分。结果:观察组患者的手术时间、术中失血量、术中输血量、术后住院时间低于对照组,全切除率高于对照组(均P<0.05); 手术后两组WBC、CRP、ESR均升高,且观察组较对照组低(均P<0.05); 观察组患者手术后的肢体麻木、视线模糊、偏瘫、呼吸障碍、高热的总不良反应发生率低于对照组(P<0.05); 治疗后两组患者MRS评分与NIHSS评分均降低,且观察组低于对照组(均P<0.05)。结论:将术前栓塞联合经对侧纵裂入路手术应用于巨大镰窦旁脑膜瘤患者,可缩短手术时间以及住院时间,减少术中失血量及输血量,提高瘤全切除率、降低炎性反应,且不良反应发生率较低,进而提升患者术后远期脑部神经功能恢复情况。
Abstract:
Objective:To explore the efficacy of preoperative embolization combined with trans-contralateral longitudinal fissure approach sugery in the treatment of giant paranasal falcate meningioma.Methods:A total of 60 patients with giant paranasal falcate meningioma were divided into observation group(30 cases)and control group(30 cases)according to different surgical methods.The observation group was treated with preoperative embolization combined with trans-contralateral longitudinal fissure approach sugery,while the control group was treated with conventional approach sugery.The operation-related indexes,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),white blood cell count(WBC)-related inflammatory factors,incidence of adverse reactions,long-term MRS score and NIHSS score were compared between the two groups.Results:The operation time,intraoperative blood loss,intraoperative blood transfusion volume and postoperative hospital stay of the observation group were lower than those of the control group,and the total resection rate was higher than that of the control group(all P<0.05).After surgery,the levels of WBC,CRP and ESR in the two groups were increased,and those of the observation group were lower than those of the control group(all P<0.05).The incidence of total adverse reactions of limb numbness,blurred vision,hemiplegia,breathing disorder and high fever in the observation group after surgery was lower than that in the control group(P<0.05).After treatment,the MRS score and NIHSS score of the two groups were decreased,and those of the observation group were lower than those of the control group(all P<0.05).Conclusion:The application of preoperative embolization combined with trans-contralateral longitudinal fissure approach sugery in patients with giant paranasal falcate meningioma can shorten the operative time and hospital stay,reduce intraoperative blood loss and blood transfusion,improve the total tumor resection rate,reduce inflammatory response,and the incidence of adverse reactions is low,thereby improving the recovery of long-term brain neurological function of patients after surgery.

参考文献/References:

[1] 张治元,王汉东,樊友武,等.桥小脑角区脑膜瘤的分型及显微外科治疗[J].中国临床神经外科杂志,2019,24(3):132-134.
[2] 王东流,管义祥.经小脑幕入路与经岩骨乙状窦前入路治疗岩斜区脑膜瘤的效果观察[J].实用癌症杂志,2020,35(3):514-516.
[3] 危 娟,冯燕英,杨惠贤.双侧大脑镰旁脑膜瘤术后排尿障碍患者的康复护理[J].护理学杂志,2019,34(4):83-84.
[4] 郑典刚,巩 忠,熊 先,等.显微神经外科联合术后伽马刀治疗矢状窦大脑镰旁脑膜瘤的效果分析[J].中国临床医生杂志,2019,47(10):1205-1208.
[5] 黄 斌,谭智灵,王荣彦,等.显微镜下微创切除手术与传统开颅手术对矢状窦旁及大脑镰旁脑膜瘤的疗效及安全性分析[J].河北医学,2020,26(4):681-686.
[6] 泮双军,马 颖,程 远.矢状窦旁脑膜瘤的诊断及治疗进展[J].国际神经病学神经外科学杂志,2007,34(6):1525-1560.
[7] 司凯闯,谢延风,但 伟,等.窦镰旁巨大脑膜瘤术中术后术区及远隔部位硬膜外血肿形成原因及处理[J].重庆医科大学学报,2018,43(5):1620-1625.
[8] 陈鑫华,杨咏波.术前栓塞治疗在蝶骨嵴脑膜瘤中的应用[J].局解手术学杂志,2019,28(6):507-509.
[9] 杨仕光,杨李轩,杨志雄,等.显微手术切除巨大矢状窦及大脑镰旁脑膜瘤探讨[J].中国实用神经疾病杂志,2011,14(13):79-80.
[10] 姜明春,刘 锋,吕世刚,等.矢状窦、镰旁巨大脑膜瘤的显微外科治疗[J].中华神经医学杂志,2011,10(9):950-952.
[11] 孙浩东,刘恩渝,吴建平,等.术前栓塞在巨大镰窦旁脑膜瘤手术切除中的应用价值分析[J].中国临床神经外科杂志,2020,25(10):1025-1029.
[12] 訾和平.hs-CRP、WBC和PLT联合检测在儿童感染性疾病诊断中的应用价值[J].陕西医学杂志,2015,44(3):330-331.
[13] 段 珊,彭 旷,王卫忠,等.慢性阻塞性肺疾病急性加重期患者血清补体C5a水平及其与肺功能、IL-6、CRP水平相关性研究[J].陕西医学杂志,2020,49(11):1344-1349.
[14] 马士超,陈秀民,齐志远,等.独活寄生汤对膝关节骨性关节炎行关节置换患者ESR、CRP、MMP-9水平的影响[J].陕西中医,2019,40(1):3-8.
[15] 于 眉,李玉波,李 玲,等.醒脑开窍针刺法治疗颅脑损伤吞咽障碍临床研究[J].陕西中医,2020,41(11):1661-1664.
[16] 王 刚,张金仿,张 茜,等.miR-494和ATF3 mRNA在脑膜瘤组织中的表达关系及意义[J].疑难病杂志,2021,20(8):920-925.
[17] 王琳琳,刘德杰.超选择性栓塞联合外科手术治疗脑膜瘤的疗效及对炎症因子水平的影响[J].医学临床研究,2019,36(6):1186-1187.
[18] 薛毅辉,王晨阳,康德智,等.经对侧纵裂入路切除中央区镰旁脑膜瘤[J].解放军医学院学报,2009,30(6):833-834.
[19] 雷振海,党连锋,肖三潮,等.窦镰旁脑膜瘤37例显微手术治疗体会[J].陕西医学杂志,2014,43(6):673-674.
[20] 杨吉鹏,李晓瞳,王同聚,等.3DSlicer软件辅助经对侧纵裂入路显微手术治疗镰旁脑膜瘤[J].中国综合临床,2021,37(5):420-425.

备注/Memo

备注/Memo:
基金项目:陕西省咸阳市重点研发计划项目(2019K02-113)
更新日期/Last Update: 2022-08-04