CAJ | 학술논문

目的：探讨岩上静脉(superior petrosal vein，SPV)保护在听神经瘤显微手术中的临床意义。方法：以2009年1月至2011年7月施行的听神经瘤显微手术共149例患者为观察对象，回顾性分析岩上静脉未保留(superior petrosal vein without protection，SPVWP)患者( SPVWP组，n=8)和岩上静脉保留(superior petrosal vein protection，SPVP)患者( SPVP组，n=141)术后发生术区血肿、小脑血肿和小脑水肿的差异。结果：149例患者中岩上静脉保留完整141例，未保留8例。8例SPVWP患者术后发生术区血肿4例，小脑水肿5例，小脑出血3例。141例SPVP患者术后发生术区血肿40例，小脑水肿56例，小脑出血12例。统计分析SPVWP组和SPVP组小脑出血的发生率差异有统计学意义(χ2=3.84，P=0.05)；术区血肿的发生率差异无统计学意义(χ2=0.646，P=0.422)；小脑水肿的发生率差异无统计学意义(χ2=0.611，P=0.434)。结论：在听神经瘤手术中，应尽可能对岩上静脉进行良好的保护，保护岩上静脉可能减少小脑出血的发生概率。
목적：탐토암상정맥(superior petrosal vein，SPV)보호재은신경류현미수술중적림상의의。방법：이2009년1월지2011년7월시행적은신경류현미수술공149례환자위관찰대상，회고성분석암상정맥미보류(superior petrosal vein without protection，SPVWP)환자( SPVWP조，n=8)화암상정맥보류(superior petrosal vein protection，SPVP)환자( SPVP조，n=141)술후발생술구혈종、소뇌혈종화소뇌수종적차이。결과：149례환자중암상정맥보류완정141례，미보류8례。8례SPVWP환자술후발생술구혈종4례，소뇌수종5례，소뇌출혈3례。141례SPVP환자술후발생술구혈종40례，소뇌수종56례，소뇌출혈12례。통계분석SPVWP조화SPVP조소뇌출혈적발생솔차이유통계학의의(χ2=3.84，P=0.05)；술구혈종적발생솔차이무통계학의의(χ2=0.646，P=0.422)；소뇌수종적발생솔차이무통계학의의(χ2=0.611，P=0.434)。결론：재은신경류수술중，응진가능대암상정맥진행량호적보호，보호암상정맥가능감소소뇌출혈적발생개솔。
Objective:To explore the clinical signiifcance of the protection of superior petrosal vein (SPV) in the microneurosurgery for acoustic neuroma. Methods:From January 2009 to July 2011, 149 cases of acoustic neuroma microsurgery were observed. hTe difference in hematoma in surgical area, cerebellar hematoma and cerebellar edema were compared between a SPV without protection group (SPVWP group, n=8) and a SPV protection group (SPVP group, n=141). Results:In the 149 patients with acoustic neuroma, the SPV was reserved in 141 patients. In the SPVWP group (8 patients), hematoma in the surgery area occurred in 4 patients, cerebellar edema in 5, and cerebellar hemorrhage in 3. In the SPVP group (141 patients), hematoma in the surgery area occurred in 40 patients, cerebellar edema in 56, and cerebellar hemorrhage in 12. hTere was signiifcant difference in the incidence of cerebellar hemorrhage (χ2=3.84, P=0.05), no signiifcant difference in the incidence of hematoma in the surgical area (χ2=0.646, respectively, P=0.422), and no significant difference in the incidence of cerebellar edema (χ2=0.611, P=0.434) between the SPVWP group and the SPVP group. Conclusion:In acoustic neuroma surgery, the SPV should be protected, which may reduce the risk of cerebellar hemorrhage.