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  

Efficacy of preoperative embolization combined with trans-contralateral longitudinal fissure approach sugery in treatment of giant paranasal falcate meningioma

作　　者：党连锋 杨春 DANG Lianfeng;YANG Chun(Department of Neurosurgery,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000,China)

机构地区：[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

出　　处：《陕西医学杂志》2022年第8期982-985,1020,共5页Shaanxi Medical Journal

基　　金：陕西省咸阳市重点研发计划项目(2019K02-113)。

摘　　要：目的: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。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,ther

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 

分 类 号：R739.45[医药卫生—肿瘤]