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探究脑膜瘤手术中估计术中出血量的影响因素。

Investigating Effective Factors on Estimated Hemorrhage Intraoperative in Brain Meningioma Surgery.

作者信息

Tabibkhooei Alireza, Azar Maziar, Alagha Ahmad, Jahandideh Javad, Ebrahimnia Feyzollah

机构信息

Department of Neurosurgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Skull Base Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Basic Clin Neurosci. 2020 Sep-Oct;11(5):631-638. doi: 10.32598/bcn.9.10.370. Epub 2020 Sep 1.

Abstract

INTRODUCTION

The primary and definitive diagnosis of meningioma is based on histological assessment; however, employing imaging methods, like Magnetic Resonance Imaging (MRI) is very helpful to describe lesion's characteristics. Accordingly, we decided to study the effect of imaging factors, like MRI data on the volume of hemorrhage (estimated blood loss) during meningioma surgery.

METHODS

This was a cross-sectional, retrospective, and analytical study. The eligible patients were those with meningioma who were candidates for surgery. A total of 40 patients with meningioma were selected and assessed. The preoperative imaging findings were recorded, then estimated blood loss during the surgery was determined.

RESULTS

A reverse association was revealed between the degree of proximity to the nearest sinus and the rate of bleeding. Furthermore, the size of the mass was positively associated with the rate of bleeding; however, there was no significant correlation between the volume of bleeding and other parameters, including the degree of edema, the volume of mass, the site of the tumor in the brain, and the histological subtype of the tumor. The mean time of operation was strongly correlated with blood loss. The rate of bleeding was more expected in hypertensive versus normotensive patients.

CONCLUSION

Bleeding in various volumes could be a frequent finding in intracranial meningioma surgery. Overall, tumor size, the duration of surgery, a history of hypertension, and distance to the nearest sinuses were the main determinants for the severity of hemorrhage in patients undergoing meningioma surgery.

摘要

引言

脑膜瘤的主要及确诊诊断基于组织学评估;然而,采用诸如磁共振成像(MRI)等影像学方法对于描述病变特征非常有帮助。因此,我们决定研究诸如MRI数据等影像学因素对脑膜瘤手术期间出血量(估计失血量)的影响。

方法

这是一项横断面、回顾性分析研究。符合条件的患者为患有脑膜瘤且适合手术的患者。共选取并评估了40例脑膜瘤患者。记录术前影像学检查结果,然后确定手术期间的估计失血量。

结果

发现与最近窦的接近程度与出血率呈负相关。此外,肿块大小与出血率呈正相关;然而,出血量与其他参数之间无显著相关性,这些参数包括水肿程度、肿块体积、肿瘤在脑内的位置以及肿瘤的组织学亚型。平均手术时间与失血量密切相关。高血压患者与血压正常患者相比,出血率更高。

结论

不同出血量在颅内脑膜瘤手术中可能是常见现象。总体而言,肿瘤大小、手术持续时间、高血压病史以及与最近窦的距离是脑膜瘤手术患者出血严重程度的主要决定因素。

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本文引用的文献

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Primary intraosseous meningioma.原发性骨内脑膜瘤。
Neurosurg Focus. 2007;23(4):E13. doi: 10.3171/FOC-07/10/E13.

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