| 王林杰,王恒,郑闻浩,杜权.微血管减压术后远隔部位硬膜下血肿的原因分析和应对策略[J].浙江中西医结合杂志,2024,34(3): |
| 微血管减压术后远隔部位硬膜下血肿的原因分析和应对策略 |
| Analysis of the Causes and Response Strategies for Subdural Hematoma at Remote Locations After Microvascular Decompression |
| 投稿时间：2023-09-21 修订日期：2024-01-29 |
| DOI： |
| 中文关键词: 微血管减压术、远隔部位、硬膜下血肿、并发症、保守治疗 |
| 英文关键词:Microvascular Decompression Surgery, Remote Locations, Subdural Hematoma, Complications, Conservative Treatment. |
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| 中文摘要: |
| 目的 本研究旨在分析微血管减压术后远隔部位硬膜下血肿形成原因,并提出相应的应对方法。 方法 对2022年1月至2022年8月期间,在我院进行首次微血管减压术(MVD)的326名三叉神经痛(TN)和面肌痉挛(HFS)患者的临床资料进行回顾性分析。详细记录了患者的性别、年龄、所患疾病种类、血压、血糖、凝血酶原时间、纤维蛋白原以及术前是否使用抗血小板药物等信息。发现术后6例远隔部位的硬膜下血肿,记录并分析他们的术后症状、血肿位置以及后续的治疗方式。 结果 3例患者血肿出现在同侧,2例在对侧,1例为双侧；5例患者保守治疗后血肿消失；1例患者因血肿增加行脑膜中动脉栓塞术。 结论 微血管减压术后应进行常规CT复查。高血压、脑脊液排放、年龄、纤维蛋白原含量、手术体位等因素可能与远隔部位硬膜下血肿的发生有关。保守治疗在大多数患者中有效。 |
| 英文摘要: |
| Objective The aim of this study is to analyze the causes of remote epidural hematoma formation after microvascular decompression surgery and propose corresponding countermeasures. Methods We retrospectively analyzed the clinical data of 326 patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS) who underwent their first microvascular decompression (MVD) surgery in our hospital from January to August 2022. Information such as patient"s gender, age, type of disease, blood pressure, blood glucose, prothrombin time, fibrinogen, and whether antiplatelet drugs were used preoperatively were recorded. Six cases of postoperative remote epidural hematoma were discovered, and their symptoms, hematoma locations, and treatment methods were documented and analyzed. Results Hematomas appeared on the same side in 3 patients, the opposite side in 2 patients, and bilaterally in 1 patient; hematomas disappeared after conservative treatment in 5 patients; and one patient underwent middle meningeal artery embolization due to increased hematoma. Conclusion Routine CT review should be performed after microvascular decompression surgery. Factors such as hypertension, cerebrospinal fluid drainage, age, fibrinogen content, and surgical position may be related to the occurrence of remote epidural hematomas. Conservative treatment is effective in most patients. |
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