与未破裂的大脑动脉瘤共存的围细胞瘤:单阶段还是分阶段的手术?
Xi Chen Wan1, Yu Xing Chen1, Ye Xiong1
1Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.
World neurosurgery
|August 6, 2023
概括
评估了细胞瘤和内动脉瘤同时存在的外科手术策略. 阶段性手术或保守性动脉瘤管理是有效的,单阶段内镜内腔方法 (EEA) 在某些情况下是可行的.
科学领域:
- 神经外科 神经外科
- 血管神经外科 血管神经外科
- 内镜头骨底部手术 进行内镜头骨底部手术
背景情况:
- 围细胞瘤和内动脉瘤同时发生并不常见.
- 对这些复杂的共存病理的有效管理策略至关重要.
研究的目的:
- 评估治疗患有周瘤和内动脉瘤同时存在的患者的手术策略.
- 评估不同治疗方法的安全性和有效性.
主要方法:
- 20名患者的医疗记录和手术视频的回顾性审查 (2017年11月至2022年10月).
- 对接受单阶段内镜内道治疗方法 (EEA),分阶段手术 (瘤切除后进行动脉瘤管理) 或瘤切除前栓塞的患者的治疗结果的分析.
- 包括保守管理的患者.
主要成果:
- 所有20名患者都经历了完整的瘤切除,并进行了稳定的动脉瘤随访.
- 三名患者接受了单阶段EEA;13名患者首先进行了瘤切除;2名患者首先进行了栓塞.
- 在2名患者中,保守的管理导致了一例动脉瘤破裂和死亡;在手术组中没有观察到CSF泄漏或感染等重大并发症.
结论:
- 阶段性手术或保守的动脉瘤管理提供了安全有效的治疗策略.
- 单个阶段的EEA是选择病例的可行选择,作为共存病理综合治疗计划的一部分.
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