Badejo Oluwakemi A, Idowu Olusola K, Balogun James A, Shokunbi Wuraola A, Amanor-Boadu Simbo D, Shokunbi Matthew T
Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Anaesthesia, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Surg Neurol Int. 2019 Feb 6;10:16. doi: 10.4103/sni.sni_180_18. eCollection 2019.
Surgical intervention in patients with hemoglobinopathies has been extensively reviewed in the literature, but information on the outcome of cranial surgery in this patient population in sub-Saharan Africa is limited.
This is a retrospective study of patients with hemoglobinopathies, who underwent brain surgery in our facility. The review covered a 5-year period. We examined patient- and surgery-related variables and described the surgical complications as well as the 60-day mortality.
A total of nine procedures (eight under general anesthesia and one under local anesthesia) were performed on seven patients with hemoglobinopathy during the study period. Eight (88.9%) of these were done in female patients and one (11.1%) in a male patient. Six (66.7%) were performed in patients with no previous history of blood transfusion. Hb SC accounted for five (55.6%), Hb SS for three (33.3%), and Hb CC for one (11.1%) procedure, respectively. Three (33.3%) of these procedures were brain tumor-related, three (33.3%) trauma-related, one (11.1%) cosmetic, one (11.1%) vascular, and one for a postoperative complication. Only one (11.1%) procedure was associated with preoperative blood transfusion, whereas there was a need for blood transfusion following five (55.6%) of the procedures. There was a mortality rate of 11.1% (1 case). Other complications were recorded after three (33.3%) of the procedures and none with five (55.6%) of the procedures.
Neurosurgery is possible and safe in patients with hemoglobin disorders. Adequate preoperative preparation, proper anesthetic techniques, meticulous surgery, and excellent postoperative care can help optimize outcome of surgical intervention in this patient population.
血红蛋白病患者的外科手术干预在文献中已有广泛综述，但撒哈拉以南非洲地区该患者群体的颅脑手术结果相关信息有限。
这是一项对在我们机构接受脑外科手术的血红蛋白病患者的回顾性研究。该综述涵盖了5年时间。我们检查了与患者和手术相关的变量，并描述了手术并发症以及60天死亡率。
在研究期间，对7例血红蛋白病患者共进行了9例手术（8例在全身麻醉下进行，1例在局部麻醉下进行）。其中8例（88.9%）为女性患者，1例（11.1%）为男性患者。6例（66.7%）手术患者既往无输血史。血红蛋白SC型占5例（55.6%），血红蛋白SS型占3例（33.3%），血红蛋白CC型占1例（11.1%）。这些手术中3例（33.3%）与脑肿瘤相关，3例（33.3%）与创伤相关，1例（11.1%）为整形手术，1例（11.1%）为血管手术，1例为术后并发症手术。只有1例（11.1%）手术与术前输血有关，而5例（55.6%）手术术后需要输血。死亡率为11.1%（1例）。3例（33.3%）手术后记录了其他并发症，5例（55.6%）手术无并发症记录。
血红蛋白病患者进行神经外科手术是可行且安全的。充分的术前准备、适当的麻醉技术、细致的手术操作以及优质的术后护理有助于优化该患者群体手术干预的结果。
