侧裂区病变周围水肿对术中脑膨出的影响  

Effect of perilesional edema on acute encephalocele during surgery for patients with lateral fissure lesion

作　　者：王首杰 冯达云 秦怀洲 蔡青 WANG Shou-jie;FENG Da-yun;QIN Huai-zhou;CAI Qing(Department of Neurosurgery,Tangdu Hospital,Air Force Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学唐都医院神经外科,西安710038

出　　处：《中国临床神经外科杂志》2021年第11期830-832,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81971129)。

摘　　要：目的探讨侧裂区病变周围水肿对术中急性脑膨出的影响。方法回顾性分析2016年3月至2020年9月手术治疗的68例侧裂区病变的临床资料。结果68例中,无-轻度周围水肿25例,中-重度周围水肿43例。中-重度周围水肿术中脑膨出发生率(60.5%,26/43)明显高于无-轻度周围水肿(24.0%,6/25;P<0.05)。多因素logistic回归分析表明,中-重度水肿是侧裂区病变发生术中脑膨出的独立危险因素(OR=3.07;95%CI 1.06~14.52;P=0.040)。结论周围周水肿是引起侧裂区病变术中急性脑膨出的重要原因,临床应充分重视,采取有效措施缓解周围水肿,可以有效避免或减少术中脑膨出。Objective To investigate the effect of perilesional edema on the acute encephalocele during surgery for the patients with lateral fissure lesion.Methods The clinical data of 68 patients with lateral fissure lesion who underwent surgery from March 2016 to September 2020 were analyzed retrospectivey.Results Of 68 patients with lateral fissure lesion,25 patients suffered from no-mild perilesional edema,and 43 from moderate-severe perilesional edema.The incidence of intraoperative acute encephalocele(60.5%,26/43)of patients with moderate-severe perilesional edema was significantly higher than that(24.0%,6/25)of patients with no-mild perilesional edema(P<0.05).Multivariate logistic regression analysis showed that moderate-severe perilesional edema was an independent risk factor for intraoperative acute encephalocele of patients with lateral fissure lesion(OR=3.07;95%CI 1.06~14.52;P=0.040).Conclusions Perilesional edema is an important cause of acute encephalocele during the operation for the patients with lateral fissure lesion.Adequeate attention should be paid to the effective measures to relieve perileisional edema,which can effectively avoid or reduce the intraoperative acute encephalocele.

关 键 词：侧裂病变 显微手术 周围水肿 术中脑膨出 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]