神经外科微创手术中的医源性血管损伤及相关并发症(英文)

Iatrogenic vascular injuries and related ischemic complications in minimally invasive neurosurgery

目的 分析748例微创神经外科手术中86例发生医源性血管损伤及脑缺血性并发症的病例。方法 748例患者行了开颅脑肿瘤切除或脑动静脉畸形切除或动脉瘤夹闭手术。分析了手术入路、脑缺血性并发症及随访资料。结果 29例患者术后发生脑梗塞;57例患者术后有脑缺血引起的一过性神经功能障碍;9例病人住院期间死亡。所有患者出院后随访期间无症状加重及死亡。结论 神经外科微创手术并非"无创",术中医源性血管损伤可能引起脑缺血性并发症。术中、术后均应采取措施保护手术入路中的蛛网膜下腔、皮层及其他血管。

Objective To study iatrogenic vascular injuries and related ischemic complications in 86 out of 748 cases undergoing minimally invasive neurosurgery. Methods 748 patients received tumor resection, AVM resection or aneurysm clipping. The data of surgical approaches, ischemic complications and follow-up records were analyzed and summarized. Results 29 patients developed postoperative cerebral infarction found by CT follow-up, and 57 had transient neurological deficit. 9 patients died during hospitalization. No deterioration or death occurred during the follow-up period. Conclusion Minimally invasive neurosurgery is not atraumatic and may result in ischemic complications following iatrogenic vascular injury. Measures should be taken to protect subarachnoid space, cortex and other vessels in the approach.