[1]王　飞　王　勇　周玮林　耿　鑫　孙　涛　余化霖.桥静脉位置及术中保留对窦镰旁脑膜瘤患者切除术后早期预后的影响[J].中国临床神经外科杂志,2015,(06):335-337.[doi:10.13798/j.issn.1009-153X.2015.06.005]
　WANG Fei,WANG Yong,ZHOU Wei-lin,et al.Effects of anatomic position and intraoperative preservation of bridging veins on prognoses early after surgery in patients with parasagittal and parafalx meningiomas[J].,2015,(06):335-337.[doi:10.13798/j.issn.1009-153X.2015.06.005]
点击复制

桥静脉位置及术中保留对窦镰旁脑膜瘤患者切除术后早期预后的影响()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年06期
页码:
335-337
栏目:
论著
出版日期:
2015-06-30

文章信息/Info

Title:
Effects of anatomic position and intraoperative preservation of bridging veins on prognoses early after surgery in patients with parasagittal and parafalx meningiomas
文章编号:
1009-153X（2015）06-0335-03
作者:
王　飞　王　勇　周玮林　耿　鑫　孙　涛　余化霖
650032 昆明，昆明医科大学第一附属医院神经外二科
通讯作者：余化霖，E-mail：wcsjwk@163.com
Author(s):
WANG Fei;  WANG Yong;  ZHOU Wei-lin;  GENG Xin;  SUN Tao;  YU Hua-lin.
The Second Department of Neurosurgery, The First Affiliated Hospital, Kunming Medical University, Kunming 650032, China
关键词:
窦镰旁脑膜瘤; 桥静脉; 预后
Keywords:
Superior sagittal sinus;  Parasegittal and parafal meningomas;  Bridging veins;  Prognosis
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2015.06.005
文献标志码:
A
摘要:
目的 探讨桥静脉解剖位置及其术中保留对窦镰旁脑膜瘤切除术后早期预后的影响。方法 回顾性分析120例窦镰旁脑膜瘤患者的临床资料，桥静脉位于矢状窦镰旁脑膜瘤表面为Ⅰ型，桥静脉位于肿瘤深部为Ⅱ型。预后不良包括术后神经功能障碍加重、新增神经功能障碍及死亡。结果 术中发现Ⅰ型95例，Ⅱ型14例，11例未发现桥静脉仅在肿瘤深部发现皮层静脉。术后早期预后不良13例（10.8%），其中死亡4例（3.3%），新增或原神经功能障碍加重9例（7.5%）。Ⅰ型病例中，52例术中离断桥静脉，早期预后11例（21.1%）；43例术中未离断桥静脉，早期预后不良1例（2.3%）；两者术后早期预后不良发生率差异显著（P<0.01）。所有病例中，52例术中离断桥静脉，早期预后不良11例（21.1%）；68例术中未离断桥静脉，早期不良预后2例（3.5%）；两者术后早期不良预后不良发生率差异显著（>P<0.01）。>结论 桥静脉位于窦镰旁脑膜瘤时，术中容易损伤；桥静脉一旦损伤，术后早期预后不良发生率显著增高；我们建议提高桥静脉的保留率以减少手术的直接并发症。
Abstract:
Objective To explore the value the position and intraoperative preservation of the bridging veins to the prognoses early after surgery in the patients with parasagittal and parafalx meningiomas. Methods Of 120 patients with parasagittal and parafalx meningiomas, 103 underwent surgery via ipsilateral transdural approach and 17 via bilateral transdural approaches. One or more than one bridging veins were on the parasagittal and parafalx meningiomas surfaces in 95 patients, the bridging veins were not on the timorous surfaces in 14 patients and the bridging veins were not seen in 11 patients. Results Of 95 patients in whom the bridging veins were on the timorous surfaces, 52 underwent cutting off bridging veins and 43 not. There were bad prognoses in 13 patients (10.8%), of whom, 4 (3.3%) died and 9 (7.5%) had the aggravation of the neurological deficits or new neurological deficits produced by the surgery. The rate of bad prognosis (21.29%, 11/52) was significantly higher in 52 patients with cutting off the bridging veins than that (2.3%, 1/43) in 43 patients without cutting off the bridging veins of 95 patients in whom the bridging veins were on the timorous surfaces (P

参考文献/References:

[1] Tomasello F, Conti A, Cardali S, et al. Venous preservation- guided resection: a changing paradigm in parasagittal meningioma surgery [J]. J Neurosurg, 2013, 119(1): 74-81.
[2] DiMeco F, Li KW, Casali C, et al. Meningiomas invading the superior sagittal sinus: surgical experience in 108 cases [J]. Neurosurgery, 2008, 62(6): 1124-1135.
[3] 张回健，费　昶，衡雪源，等. 脑膜瘤级别及其临床特点 [J]. 中华神经外科杂志，2011，27（12）：1244-1246.
[4] Bi N, Xu RX, Liu RY, et al. Microsurgical treatment for parasagittal meningioma in the central gyrus region [J]. Oncol Lett, 2013, 6(3): 781-784.
[5] Nagata T, Ishibashi K, Metwally H, et al. Analysis of venous drainage from sylvian veins in clinoidal meningiomas [J]. World Neursurg, 2013, 79(1): 116-123.
[6] 张俊廷，王忠诚，吴　震，等. 枕骨大孔区脑膜瘤的显微手 术治疗[J]. 中华神经外科杂志，2000，16（3）：159-161.
[7] 徐子明，余新光，宋志惠，等. 上矢状窦中后部脑膜瘤导致 静脉窦闭塞后静脉代偿特点及意义[J]. 中华神经外科杂 志，2003，19（3）： 170-173.
[8] 刘阿力，王军梅，李桂林，等. 伽玛刀治疗后脑膜瘤再手术 原因及病理学分析[J]. 中华神经外科杂志，2013，29（5）： 435-440.
[9] 张运良，黄　亮，许永刚，等. 矢状窦旁脑膜瘤的显微手术 治疗技巧[J]. 中国临床神经外科杂志，2012，17：235-237.
[10] 秦　虎，周庆九，刘　波，等. 磁共振静脉成像对矢状窦镰 旁脑膜瘤的术前评估[J]. 中华神经外科杂志，2012，28 （9）：927-930.
[11] 张荣伟，许　峰，袁绍纪，等. 320排CT灌注成像对矢状 窦旁脑膜瘤诊治的价值[J]. 中国临床神经外科杂志， 2011，16：517-519.
[12] 余龙洋，李亚楠，韩国胜，等. 神经导航多模态融合技术在 窦镰旁脑膜瘤手术中的初步应用[J]. 中国临床神经外科 杂志，2015，20：75-77.
[13] Ueba T, Okawa M, Abe H, et al. Identification of venoussi- nus, tumorlocation, and pial supply during meningioma surgery by transdural indocyanine green videography [J]. J Neurosurg, 2013, 118(3): 632-636.
[14] Nakasu S, Fukami T, Jito J, et al. Microsc opicanatomy of the brain-meningioma interface [J]. BrainTumor Pathol, 2005, 22(2): 53-57.
[15] Lynch JC, Schiavini H, Bomfim C, et al. Microsurgical resection for parasagittal meningiomas with preservation of the parasagittal sinus and excellent neurovascular control [J]. Arq Neuropsiquiatr, 2013, 71(5): 301-306.
[16] 丁学华，卢亦成，陈志刚，等. 窦镰旁脑膜瘤的显微手术 治疗[J]. 中华神经外科杂志，2003，19（3）：226-228.
[17] Nussbaum ES, Defillo A, Janjua TN, et al. Microvascular repair of an injured cortical draining vein [J]. Surg Neurol, 2009, 72(5): 530-531.
[18] Rogers L1, Barani I, Chamberlain M, et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review [J]. Neurosurg, 2015, 122(1): 4-23.

相似文献/References:

[1]余龙洋　李亚楠　韩国胜　岳志健.神经导航多模态融合在窦镰旁脑膜瘤手术中的初步应用[J].中国临床神经外科杂志,2015,(02):75.[doi:10.13798/j.issn.1009-153X.2015.02.003]
　YU Long-yang,LI Ya-nan,HAN Guo-sheng,et al.Preliminary application of neuronavigation multi-mode fusion to microsurgery for parasagittal and parafalx meningiomas[J].,2015,(06):75.[doi:10.13798/j.issn.1009-153X.2015.02.003]
[2]石勇,秦军,牟磊.显微手术治疗窦镰旁脑膜瘤的疗效分析[J].中国临床神经外科杂志,2022,27(10):809.[doi:10.13798/j.issn.1009-153X.2022.10.003]
　SHI Yong,QIN Jun,MOU Lei.Surgical outcomes of parasagittal sinus and parafalx meningiomas[J].,2022,27(06):809.[doi:10.13798/j.issn.1009-153X.2022.10.003]

备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81260182）；云南省科技厅联合专项研究基金（2012FB036）
更新日期/Last Update: 2015-06-30