听神经瘤切除术后脑血管痉挛的危险因素分析

发布时间：2018-03-16 19:34

本文选题：听神经瘤　切入点：血管痉挛　出处：《中国现代医学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的探讨经乙状窦后入路切除听神经瘤患者术后脑血管痉挛发生的潜在危险因素。方法选取2010年1月-2015年2月该院接受听神经瘤切除术患者153例。术后病理结果显示听神经瘤,且经乙状窦后入路手术,按纳入和排除标准,回顾性分析其中80例符合要求的患者,按照经颅多普勒对术前及术后1、3、5、7和9 d的椎基底动脉、颈内动脉、大脑中动脉、大脑前动脉血流速度及频谱的监控结果,将其分为血管痉挛组(43例)和血管未痉挛组(37例),分析两组患者一般资料及其临床相关指标,并采用多因素Logistic回归分析影响听神经瘤患者术后脑血管痉挛发生的危险因素。结果两组患者年龄、肿瘤最大直径、肿瘤质地、与三叉神经或脑干粘连方面比较,差异有统计学意义(P0.05)。多因素Logistic回归分析结果显示,年龄(OR=0.936,P=0.035),肿瘤最大直径(OR=5.327,P=0.046),肿瘤质地(OR=143.757,P=0.023)为脑血管痉挛危险因素。结论听神经瘤术前年龄较小、肿瘤直径较大,术中可见肿瘤质地较韧的患者易并发术后脑血管痉挛。
[Abstract]:Objective to investigate the retrosigmoid resection to potential risk factors for patients with cerebral vasospasm neuroma. Methods from January 2010 -2015 year in February the hospital to 153 patients with neuroma. Postoperative pathological results showed that the acoustic neuroma, and through retrosigmoid surgery, according to the inclusion and exclusion criteria a retrospective analysis, including 80 cases of patients who meet the requirements, in accordance with TCD on preoperative and postoperative 1,3,5,7 and 9 D of vertebrobasilar artery, internal carotid artery, middle cerebral artery, blood flow velocity and spectrum monitoring results of the brain, which can be divided into vasospasm group (43 cases) and vascular spasm group (not analysis of 37 cases), two groups of patients with general information and related clinical indicators, and using multivariate Logistic regression analysis of risk factors affect listening neuroma patients postoperative cerebral vasospasm occurred. Results two groups of patients with age, the maximum diameter of the tumor, Tumor texture, compared with the trigeminal nerve and brainstem adhesion, the difference was statistically significant (P0.05). Multivariate Logistic regression analysis showed that age (OR=0.936, P=0.035), the maximum diameter of tumor (OR=5.327, P=0.046), tumor texture (OR=143.757, P=0.023) were risk factors of cerebral vasospasm. Conclusion acoustic neuroma surgery before age the smaller, larger tumor diameter, were visible with dense texture of tumor patients complicated with postoperative cerebral vasospasm.

【作者单位】：郑州大学第二附属医院神经外科;
【分类号】：R739.4

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