巨大脑膜瘤手术并发症分析(1)
[摘要] 目的 研究巨大脑膜瘤手术并发症的影响因素及危害，总结防治经验。 方法 回顾性分析2011年9月～2016年9月郑州大学第一附属医院神经外科收治的64例巨大脑膜瘤患者的临床资料，采用KPS评分评估患者生活质量，应用多因素Logistic回归统计数据，然后结合临床及相关文献总结手术并发症的发生原因、影响因素、预防措施及预后。 结果 单因素分析显示：年龄、术前KPS评分、肿瘤部位、切除程度与手术并发症发生有关(P < 0.05)。多因素分析显示：年龄≥60岁、肿瘤未全切是发生手术并发症的独立危险因素(P < 0.05)，重度脑水肿、颅内出血是影响围术期转归的独立危险因素(P < 0.05)。 结论 重度脑水肿、颅内出血是巨大脑膜瘤的严重手术并发症，患者年龄大、肿瘤未全切是造成手术并发症的独立危险因素，科学精细的手术操作及合理的围术期管理可减少手术并发症的危害。
[关键词] 巨大脑膜瘤；并发症；围术期；脑水肿；颅内出血
[中图分类号] R739.4 [文献标识码] A [文章编号] 1673-7210(2017)06(b)-0096-04
Analysis of surgical complications of huge meningiomas
WANG Rui SUN Hongwei WANG Chao ZHANG Rende LI Dongming
Department of Neurosurgery， First Affiliated Hospital of Zhengzhou University， He'nan Province， Zhengzhou 450052， China
[Abstract] Objective To study the influencing factors and harm of the surgical complications of huge meningiomas， and summarize the experience for huge meningiomas prevention and treatment. Methods The clinical data of 64 patients with huge meningioma were analyzed retrospectively from September 2011 to September 2016 in the First Affiliated Hospital of Zhengzhou University. The quality of life was assessed by KPS score. Single factor chi-square test and multiple factor Logistic regression for statistics data，and then combined with clinical and related literature to summarize the causes of surgical complications， influencing factors， preventive measures and outcome. Results Univariate analysis showed that age， preoperative KPS score， tumor location and degree of resection were related to the surgical complications (P < 0.05). Multivariate analysis showed that age was ≥60 years old and incomplete resection were independent risk factors for complications. Severe cerebral edema and intracranial hemorrhage are independent risk factors for perioperative outcome (P < 0.05). Conclusion Severe cerebral edema and intracranial hemorrhage are serious complications of huge meningioma. The patients are older and the tumor is incomplete resection were Independent risk factors for surgical complications. Scientific and fine surgical operation and reasonable perioperative management can be reduced the risk of surgical complications.
[Key words] Huge meningioma； Complications； Perioperative； Cerebral edema； Intracranial hemorrhage
脑膜瘤是最常见的原发中枢神经系统肿瘤，发病率为4.52/10万人，93%腦膜瘤属于良性肿瘤[1]。脑膜瘤生长缓慢，某些患者直至瘤体很大时才出现临床症状。脑膜瘤的大小分型尚未统一，不过多数学者倾向于将长径大于7.0 cm的称为巨大脑膜瘤[2-4]，这种脑膜瘤手术难度高，手术并发症多。本文回顾性分析2011年9月～2016年9月郑州大学第一附属医院神经外科收治的巨大脑膜瘤患者的临床资料，总结其常见手术并发症的防治经验，现报道如下：, 百拇医药(王睿 孙红卫 王超 张仁德 李东明)
[关键词] 巨大脑膜瘤；并发症；围术期；脑水肿；颅内出血
[中图分类号] R739.4 [文献标识码] A [文章编号] 1673-7210(2017)06(b)-0096-04
Analysis of surgical complications of huge meningiomas
WANG Rui SUN Hongwei WANG Chao ZHANG Rende LI Dongming
Department of Neurosurgery， First Affiliated Hospital of Zhengzhou University， He'nan Province， Zhengzhou 450052， China
[Abstract] Objective To study the influencing factors and harm of the surgical complications of huge meningiomas， and summarize the experience for huge meningiomas prevention and treatment. Methods The clinical data of 64 patients with huge meningioma were analyzed retrospectively from September 2011 to September 2016 in the First Affiliated Hospital of Zhengzhou University. The quality of life was assessed by KPS score. Single factor chi-square test and multiple factor Logistic regression for statistics data，and then combined with clinical and related literature to summarize the causes of surgical complications， influencing factors， preventive measures and outcome. Results Univariate analysis showed that age， preoperative KPS score， tumor location and degree of resection were related to the surgical complications (P < 0.05). Multivariate analysis showed that age was ≥60 years old and incomplete resection were independent risk factors for complications. Severe cerebral edema and intracranial hemorrhage are independent risk factors for perioperative outcome (P < 0.05). Conclusion Severe cerebral edema and intracranial hemorrhage are serious complications of huge meningioma. The patients are older and the tumor is incomplete resection were Independent risk factors for surgical complications. Scientific and fine surgical operation and reasonable perioperative management can be reduced the risk of surgical complications.
[Key words] Huge meningioma； Complications； Perioperative； Cerebral edema； Intracranial hemorrhage
脑膜瘤是最常见的原发中枢神经系统肿瘤，发病率为4.52/10万人，93%腦膜瘤属于良性肿瘤[1]。脑膜瘤生长缓慢，某些患者直至瘤体很大时才出现临床症状。脑膜瘤的大小分型尚未统一，不过多数学者倾向于将长径大于7.0 cm的称为巨大脑膜瘤[2-4]，这种脑膜瘤手术难度高，手术并发症多。本文回顾性分析2011年9月～2016年9月郑州大学第一附属医院神经外科收治的巨大脑膜瘤患者的临床资料，总结其常见手术并发症的防治经验，现报道如下：, 百拇医药(王睿 孙红卫 王超 张仁德 李东明)