CAJ | 학술논문

目的探讨三维血管成像在老年脑膜瘤中手术方案制定的应用价值. 方法对42例年龄≥60岁的老年脑膜瘤患者进行多层螺旋CT血管成像(MSCTA)及或三维增强磁共振血管成像(3D CE-MRA)检查(模拟组),在三维成像处理工作站中进行术前手术风险分析,并以同期未经上述检查的28例老年脑膜瘤患者作为对照组.比较两组术中手术操作时间、出血量及术后并发症的差异. 结果模拟组42例皆于术前合理地制定手术方案及手术入路,模拟组术后并发症发生率35.7％低于对照组50.0％ (P＞0.05)；术中输血量(531.0±150.6) ml低于对照组(621.4±226.7)ml(t=2.01,P=0.049)；手术时间(257.1±72.6)min低于对照组(307.5±88.2) min(t=2.61,P=0.011). 结论应用三维血管成像技术对老年脑膜瘤患者进行术前风险度评估,帮助临床合理地制定手术方案及手术入路,降低手术创伤及并发症.
목적 탐토삼유혈관성상재노년뇌막류중수술방안제정적응용개치. 방법 대42례년령≥60세적노년뇌막류환자진행다층라선CT혈관성상(MSCTA)급혹삼유증강자공진혈관성상(3D CE-MRA)검사(모의조),재삼유성상처리공작참중진행술전수술풍험분석,병이동기미경상술검사적28례노년뇌막류환자작위대조조.비교량조술중수술조작시간、출혈량급술후병발증적차이. 결과 모의조42례개우술전합리지제정수술방안급수술입로,모의조술후병발증발생솔35.7％저우대조조50.0％ (P＞0.05)；술중수혈량(531.0±150.6) ml저우대조조(621.4±226.7)ml(t=2.01,P=0.049)；수술시간(257.1±72.6)min저우대조조(307.5±88.2) min(t=2.61,P=0.011). 결론 응용삼유혈관성상기술대노년뇌막류환자진행술전풍험도평고,방조림상합리지제정수술방안급수술입로,강저수술창상급병발증.
Objective To study the preoperative application value of the three-dimensional angiography in surgical strategy for the elderly patients with meningioma. Methods Forty-two elderly patients aged 60 years and over with meningioma were examined preoperatively with multi-slice spiral CT angiography(MSCTA) and (or) 3 dimensional contrast-enhancement MR angiography(3D CE-MRA)as simulation group.In three-dimensional post-processing workstation,the oppression and invasion degree of the intracranial important blood vessels,nervous running zone and sinus,as well as surgical risks were evaluated. 28 elderly patients without the above examination were as control group. The operation time, blood transfusions and postoperative complications were compared between the two groups. Results All 42 cases of simulation group completed reasonable surgical plan and approach.The incidence of postoperative complications were lower in simulation group than in control group (35.7％ vs.50.0％,P＞0.05),intra-operative blood transfusion were significantly decreased in simulation group as compared with control group [(5301.0± 150.6) ml vs.( 621.4±226.7)ml,t=2.01,P=0.049],operation time after three-dimensional simulation were reduced as compared with control group [(257.1 ±72.6) min vs.(307.5±88.2)min,t=2.61,P=0.011].Conclusions Application of three-dimensional angiography in elderly patients with meningioma to evaluate the operative risk may help make reasonable surgical strategy,thus reducing the surgical trauma and complications.