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三角区脑膜瘤术后颞角嵌顿的危险因素和结果。

Risk Factors for and Outcomes of Postoperative Entrapped Temporal Horn in Trigone Meningiomas.

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, People's Republic of China.

出版信息

Neurol India. 2022 May-Jun;70(3):965-971. doi: 10.4103/0028-3886.349637.

Abstract

BACKGROUND

Meningioma in the ventricle triangle area is a benign tumor that can be cured by surgery, but postoperative entrapped temporal horn may seriously affect the patient's quality of life and even require a second operation. Currently, there are few reports on this complication.

OBJECTIVE

The risk factors and prognosis of postoperative ETH in trigone meningiomas were investigated.

MATERIAL AND METHODS

A retrospective analysis of the clinical data of 87 patients with trigone meningioma from 2010 to 2018 was performed, and univariate and multivariate analyses were used to assess the risk factors associated with postoperative ETH. The degree of ETH was evaluated using the modified ventriculocranial ratio.

RESULTS

The incidence of postoperative ETH in trigone meningioma was 29.9% (26/87). Preoperative ETH [odds ratio (OR): 4.826, 95% confidence interval (CI): 1.820-12.796, P = 0.002] and postoperative meningitis (OR: 12.811, 95%CI: 1.615-101.605, P = 0.016) are independent risk factors for postoperative ETH. Of the 18 patients with ETH syndrome, 12 improved after medical treatment, and finally, a total of 6 patients received ETH surgery. The mean duration from tumor resection to the appearance of ETH syndrome was 3.1 ± 1.9 months (range: 9 days-7 months). Patients with ETH grade II and III are more prone to clinical symptoms.

CONCLUSIONS

: The incidence of postoperative ETH for trigone meningiomas is high, and clinical symptoms generally appear delayed after surgery. Reducing postoperative infections can reduce the occurrence of postoperative ETH. Patients with symptoms of ETH who have failed medical treatment have clear indications for surgery.

摘要

背景

脑室三角区脑膜瘤是一种良性肿瘤,可通过手术治愈,但术后出现的额角脑室可能严重影响患者的生活质量,甚至需要再次手术。目前,关于这种并发症的报道较少。

目的

探讨三角区脑膜瘤术后额角脑室出现(entrapped temporal horn,ETH)的危险因素及预后。

材料与方法

回顾性分析 2010 年至 2018 年收治的 87 例三角区脑膜瘤患者的临床资料,采用单因素及多因素分析评估术后发生 ETH 的相关危险因素。采用改良脑室颅比评估 ETH 程度。

结果

三角区脑膜瘤术后 ETH 的发生率为 29.9%(26/87)。术前 ETH(比值比:4.826,95%置信区间:1.820-12.796,P=0.002)和术后脑膜炎(比值比:12.811,95%置信区间:1.615-101.605,P=0.016)是术后 ETH 的独立危险因素。18 例出现 ETH 综合征的患者中,12 例经药物治疗后好转,最终有 6 例行 ETH 手术。肿瘤切除至 ETH 综合征出现的平均时间为 3.1±1.9 个月(范围:9 d-7 个月)。ETH Ⅱ级和Ⅲ级患者更易出现临床症状。

结论

三角区脑膜瘤术后 ETH 的发生率较高,术后症状一般延迟出现。减少术后感染可降低术后 ETH 的发生。药物治疗失败的 ETH 患者有明确的手术适应证。

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