手术后的大脑静脉鼻血栓在逆形骨切除后 - - 临床和放射学分析
Lukasz Przepiorka1, Katarzyna Wójtowicz1, Katarzyna Camlet1
1Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland.
Brain sciences
|July 29, 2023
概括
手术后的大脑静脉鼻血栓形成 (CVST) 在逆形手术后很少见. 横鼻腔和主导侧手术的较低暴露与放射性CVST相关,这表明这些因素可能会增加风险.
科学领域:
- 神经外科 神经外科
- 血管神经学 血管神经学
- 放射学 放射学是一门学科.
背景情况:
- 大脑静脉鼻血栓 (CVST) 是神经外科手术后的一种罕见但严重的并发症.
- 通常用于后腔病理的逆西格形方法,具有相邻静脉鼻中阳性损伤或血栓形成的风险.
- 关于手术后CVST的特定风险因素和发病率,在逆形手术后存在有限的文献.
研究的目的:
- 调查手术后大脑静脉鼻血栓 (CVST) 的发生率和潜在风险因素,在接受逆形治疗的患者中.
- 要区分放射性CVST (rCVST) 和临床明显的CVST (cCVST).
- 探索对西格体和横侧鼻的手术暴露与rCVST和cCVST的发展之间的关系.
主要方法:
- 一个回顾性分析的130名患者,他们接受了回复性肌肉手术.
- 根据CVST (rCVST) 的放射性证据或住院期间的临床诊断 (cCVST) 来对患者进行分类.
- 放射性CVST被鉴定为缺少西格体 (SS) 或横侧鼻 (TS) 的对比度. 从切割到鼻的最近距离被测量以量化鼻暴露. 进行了统计分析以评估相关性.
主要成果:
- 整体rCVST发生率为46.9%,主要在横鼻腔 (65.6%). 临床CVST (cCVST) 在3.1%的病例中发生.
- 对于cCVST,在鼻附近没有发现显著差异.
- 横鼻腔暴露较低与rCVST发病率较低相关 (p=0.009). 主导鼻侧的手术与更高的rCVST频率相关 (p=0.042).
结论:
- 主导鼻侧的手术方法和鼻暴露的程度似乎与放射性CVST的发展有关.
- 虽然临床CVST很少见,但放射学发现表明横侧鼻血栓的发病率较高.
- 需要进一步的前性研究来阐明确定的风险因素,并优化术后CVST的管理策略.
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