Amcheslavskiĭ V G, Dziubanova N A, Lobanov S A, Korshunov A G, Kulikovskiĭ V P
Anesteziol Reanimatol. 1991 Jan-Feb(1):30-5.
255 patients have been examined in the early postoperative period after the removal of tumors located in diencephalic and sella turcica regions. The early postoperative period was complicated by circulation disturbances in the vascular bed of the anterior cerebral or anterior communicative arteries. The clinical pattern, CT scans and morphological data were analysed. Three principal clinical syndromes of the postoperative period were lined out: 1) extrapyramidal-diencephalic syndrome; 2) extrapyramidal-capsular syndrome; 3) frontal-corpocallosal syndrome. The reason for these syndromes was the occlusion of the anterior cerebral and anterior communicative arteries or their branches. The diencephalic syndrome had poor prognosis. The postoperative therapy included hormones. It was necessary to prevent the onset of adrenal insufficiency and diabetes insipidus. The differential diagnosis of thrombosis and vasospasm was of great importance. In case of vasospasm, such medicines as sermion, redergine and nimodipine had a strong therapeutic effect. In vascular thrombosis these medicines were ineffective. Systemic approach to circulation disturbances seems of utmost importance for the analysis of postoperative complications.
对255例位于间脑和蝶鞍区肿瘤切除术后早期的患者进行了检查。术后早期出现了大脑前动脉或前交通动脉血管床循环障碍的并发症。对临床症状、CT扫描和形态学数据进行了分析。术后出现了三种主要临床综合征:1)锥体外系-间脑综合征;2)锥体外系-囊综合征;3)额叶-胼胝体综合征。这些综合征的原因是大脑前动脉和前交通动脉及其分支闭塞。间脑综合征预后不良。术后治疗包括使用激素。必须预防肾上腺功能不全和尿崩症的发生。血栓形成和血管痉挛的鉴别诊断非常重要。对于血管痉挛,如喜得镇、利血平和尼莫地平等药物有很强的治疗效果。对于血管血栓形成,这些药物无效。对循环障碍采取系统的方法对于分析术后并发症似乎至关重要。