岩上静脉保护在听神经瘤显微手术中的临床意义  

Protection of the superior petrosal vein in microneurosurgery for acoustic neuroma

作　　者：奚健[1] 丁锡平[1] 彭泽峰[1] 刘庆[1] 袁贤瑞[1] 

机构地区：[1]中南大学神经外科研究所,中南大学湘雅医院神经外科,湖南省颅底外科与神经肿瘤临床医疗技术研究中心

出　　处：《中南大学学报（医学版）》2013年第7期695-698,共4页Journal of Central South University ：Medical Science

基　　金：湖南省科技计划项目(2009FJ3154)~~

摘　　要：目的:探讨岩上静脉(superior petrosal vein,SPV)保护在听神经瘤显微手术中的临床意义。方法:以2009年1月至2011年7月施行的听神经瘤显微手术共149例患者为观察对象,回顾性分析岩上静脉未保留(superior petrosalve in with out protection,SPVWP)患者(SPVWP组,n=8)和岩上静脉保留(superior petrosalve in protection,SPVP)患者(SPVP组,n=141)术后发生术区血肿、小脑血肿和小脑水肿的差异。结果:149例患者中岩上静脉保留完整141例,未保留8例。8例SPVWP患者术后发生术区血肿4例,小脑水肿5例,小脑出血3例。141例SPVP患者术后发生术区血肿40例,小脑水肿56例,小脑出血12例。统计分析SPVWP组和SPVP组小脑出血的发生率差异有统计学意义(χ2=3.84,P=0.05);术区血肿的发生率差异无统计学意义(χ2=0.646,P=0.422);小脑水肿的发生率差异无统计学意义(χ2=0.611,P=0.434)。结论:在听神经瘤手术中,应尽可能对岩上静脉进行良好的保护,保护岩上静脉可能减少小脑出血的发生概率。Objective： To explore the clinical significance of the the microneurosurgery for acoustic neuroma. protection of superior petrosal vein （SPV） in Methods： From January 2009 to July 2011, 149 cases of acoustic neuroma microsurgery were observed. The difference in hematoma in surgical area, cerebellar hematoma and cerebellar edema were compared between a SPV without protection group （SPVWP group, n=8） and a SPV protection group （SPVP group, n=141）. Results： In the 149 patients with acoustic neuroma, the SPV was reserved in 141 patients. In the SPVWP group （8 patients）, hematoma in the surgery area occurred in 4 patients, cerebellar edemain 5, and cerebellar hemorrhage in 3. In the SPVP group （141 patients）, hematoma in the surgery area occurred in 40 patients, cerebellar edema in 56, and cerebellar hemorrhage in 12. There was significant difference in the incidence of cerebellar hemorrhage （χ2=3.84, P=0.05）, no significant difference in the incidence ofhematoma in the surgical area （χ2=0.646, respectively, P=0.422）, and no significant difference in the incidence of cerebellar edema （χ2=0.611, P=0.434） between the SPVWP group and the SPVP grou.Conclusion： In acoustic neuroma surgery,the SPV should be protected, which may reduce the risk of cerebellar hemorrhage.

关 键 词：岩上静脉 听神经瘤 小脑出血 

分 类 号：R739.4[医药卫生—肿瘤]