Liu Jiang, Shen Yuxiao, Xiayizhati Kelisitan, Yu Yanbing
Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, China.
Department of Neurosurgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.
Front Surg. 2023 Jan 6;9:943848. doi: 10.3389/fsurg.2022.943848. eCollection 2022.
The biomedical glue sling technique is a convenient and effective method for vertebrobasilar artery-associated cranial nerve diseases but postoperative hemorrhage is poorly understood.
We retrospectively reviewed 14 of 1157 patients associated with cranial nerve diseases who were subjected to the biomedical glue sling technique in microvascular decompression at our hospital from January 2015 to January 2020.
There were 14 patients with cranial nerve diseases included in this study. A clinical diagnosis of postoperative hemorrhage was made after an average of 41.75 h (ranging between 0.5 and 95 h). A cerebellopontine angle hemorrhage was presented in 5 patients, while basal ganglia hemorrhage was observed in 2 patients. Both a cerebellopontine angle and brainstem hemorrhage was seen in 1 patient. Distal supratentorial subdural hemorrhage was recorded in 6 patients. The correlation coefficient was -0.1601 ( = 0.7094) between the standard deviation of systolic blood pressure and the Hemphill Score, -0.2422 ( = 0.5633) between the coefficient of variation of systolic blood pressure and the Hemphill Score, and -0.0272 ( = 0.9489) between the range of systolic blood pressure and the Hemphill Score.
The incidence of postoperative hemorrhage after MVD with the biomedical glue sling technique is higher than with traditional MVD and most cases have a favorable prognosis. Postoperative symptoms are the main area of concern and changes in symptoms usually suggest the occurrence of hemorrhage. Several factors, including surgical procedures, the release of CSF, and blood pressure might be associated with hemorrhaging. We still believe such a technique is an efficient approach to treating complicated cranial nerve diseases.
生物医学胶水悬吊技术是治疗椎基底动脉相关性颅神经疾病的一种便捷有效的方法,但对术后出血情况了解甚少。
我们回顾性分析了2015年1月至2020年1月在我院接受微血管减压术并采用生物医学胶水悬吊技术治疗的1157例颅神经疾病患者中的14例。
本研究纳入14例颅神经疾病患者。术后平均41.75小时(0.5至95小时)做出术后出血的临床诊断。5例出现桥小脑角出血,2例观察到基底节出血。1例同时出现桥小脑角和脑干出血。6例记录到幕上远段硬膜下出血。收缩压标准差与Hemphill评分的相关系数为-0.1601(P = 0.7094),收缩压变异系数与Hemphill评分的相关系数为-0.2422(P = 0.5633),收缩压范围与Hemphill评分的相关系数为-0.0272(P = 0.9489)。
采用生物医学胶水悬吊技术的微血管减压术后出血发生率高于传统微血管减压术,且多数病例预后良好。术后症状是主要关注领域,症状变化通常提示出血发生。包括手术操作、脑脊液释放和血压在内的几个因素可能与出血有关。我们仍然认为这种技术是治疗复杂颅神经疾病的有效方法。