摘要
目的探讨影响脑膜瘤术后脑水肿加重的危险因素。方法回顾性分析2016年1月1日至2018年2月5日在我院神经外科手术治疗的187例脑膜瘤患者的临床资料及术后脑水肿加重的发生情况,统计影响脑膜瘤术后脑水肿加重的相关危险因素。结果术前无瘤周水肿的脑膜瘤患者术后发生水肿加重的发生率(26.23%)高于术前存在瘤周水肿患者(13.8%),可能由于病例数不足等原因,差异并无统计学意义,但是将所有相关因素一起进行多因素分析发现术前有无瘤周水肿是脑膜瘤术后脑水肿加重的影响因素(P=0.005)。通过单因素分析发现,肿瘤部位是脑膜瘤术后脑水肿加重的危险因素;通过多因素分析及多个率的多重比较发现,窦镰旁部位是脑膜瘤术后脑水肿加重的独立危险因素。结论脑膜瘤术前存在瘤周水肿可能是其术后脑水肿加重的一个保护性因素。位于窦镰旁部位的脑膜瘤,术后脑水肿加重的发生率明显高于其他部位,因此对位于窦镰旁部位的脑膜瘤,临床上应予以高度重视,术中注意引流静脉的保护,加强围手术期管理,及时予以激素和后续的脱水治疗,以改善患者的预后。
Objective To investigate the risk factors of aggravated cerebral edema after meningioma surgery.Methods Respectively analyze the clinical data of 187 patients received neurosurgery operation in our hospital from January 1,2016 to February 5,2018 and their postoperative aggravated cerebral edema,the related risk factors for brain edema after meningioma surgery was summarized.Results The incidence of aggravated cerebral edema in patients without preoperative edema(26.23%)was higher than that in patients with preoperative edema(13.8%),the difference was not statistically significant,probably due to the small number of cases or other related factors.Multivariate analysis of all related factors found that preoperative edema was the influencing factor for the increase of brain edema after meningioma surgery(P=0.005).It was found by single factor analysis that tumor site was a risk factor for the aggravation of cerebral edema after meningioma surgery.Multivariate analysis and multiple rate comparisons revealed that the sagittal sinus falx area was an independent risk factor for the aggravation of cerebral edema after meningioma surgery.Conclusion The presence of peritumoral edema before surgery may be a protective factor for the postoperative brain edema.The incidence of postoperative cerebral edema was significantly higher in meningiomas located near the sagittal sinus falx than that of other sites.Therefore,meningiomas located near the sagittal sinus falx should be attached great importance.During the operation,the venous drainage should be protected,the perioperative management should be strengthened,and hormone and subsequent dehydration should be given timely to improve the prognosis of patients.
作者
赵青
李顺
汤阳阳
赵传
谢满意
李中林
ZHAO Qing;LI Shun;TANG Yang-yang;ZHAO Chuan;XIE Man-yi;LI Zhong-lin(Department of Neurosurgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221000,China)
出处
《局解手术学杂志》
2019年第1期55-59,共5页
Journal of Regional Anatomy and Operative Surgery
基金
江苏省研究生科研与实践创新计划项目(SJCX17_0551)
关键词
脑膜瘤
术后脑水肿
危险因素
瘤周水肿
meningioma
postoperative cerebral edema
risk factor
peritumoral edema
