预防性治疗措施对小脑肿瘤术后脑缺血改善作用.docVIP

预防性治疗措施对小脑肿瘤术后脑缺血改善作用 　　【摘要】目的：观察小脑肿瘤切除术前后应用预防性治疗措施对术后脑缺血的改善情况。方法：86例小脑肿瘤手术患者随机分为两组，治疗组术前术后应用改善循环药物，同时应用甲强龙减轻脑水肿，术中强调缩短开颅时间、细心操作、避免过度牵拉等注意事项，对照组常规手术治疗。结果：治疗组术后脑缺血阳性率较对照组低，差异有统计学意义(P0.05)。结论：小脑肿瘤术前术后预防性措施及术中高水平操作可减少脑缺血的发生，患者术后生存质量更高，值得临床推广。 　　【关键词】小脑肿瘤；脑缺血;预防性治疗 　　 　　The Improvement of Preventive Treatment Measures on Cerebellar Tumor Resection Cerebral Ischemia/HUANG Yu-chi，ZHANG Tian-yi，LIU Yong，et al.//Medical Innovation of China，2012，9(10)：035-036 　　【Abstract】Objective：To observe the application of preventive treatment and measures to improve the postoperative cerebral ischemia before and after cerebellar tumor resection.Methods：88 cases of cerebellar tumor surgery were randomly divided into 2 groups，the treatment of preoperative and postoperative improvement of the cycle of drug，methylprednisolone and cerebral edema，emphasis on shorter craniotomy time，careful operation and precautions to avoid excessive traction，the control group took conventional surgical treatment.Results：The incidence of cerebral ischemia in the treatment group was less than the control group(P0.05)，there was significant difference between them.Conclusion：Prophylactic measures before the conclusion cerebellar tumor surgery and intraoperative high-level operation can reduce the occurrence of cerebral ischemia，postoperative survival quality was higher，it is worthy of clinical application. 　　【Key words】Cerebellar tumor;Cerebral ischemia;Preventive therapy 　　First-author’s address：Xingning People’s Hospital，Xingning 514500，China 　　doi：10.3969/j.issn.1674-4985.2012.10.020 　　 　　脑肿瘤术后有较高的脑缺血发生率，据统计小脑肿瘤术后脑缺血的发生率为14.3%，在二级以下医院发生率更高，笔者所在医院尝试在小脑肿瘤患者术前术后应用改善循环药物，同时应用甲强龙减轻脑水肿，术中高水平细致操作，使小脑肿瘤术后患者脑缺血发作率降低，现报道如下。 　　1资料与方法 　　1.1一般资料选择2004-2011年笔者所在医院86例患者，所有病例通过统计学随机化分组表按患者来诊顺序依次列入治疗组及对照组，其中治疗组47例，男25例，女22例，年龄25~85岁，中位年龄39岁；对照组39例，男22例，女17例，中位年龄40岁。病例均经头部MRI扫描确诊为小脑肿瘤，符合手术标准。两组年龄、性别等一般资料比较差异均无统计学意义(P0.05)，具有可比性。 　　1.2 方法 　　1.2.1治疗组术前术后均予以尼莫地平20 mg，3次/d，生理盐水250 ml+小剂量丹参注射液10 ml，术后1周。术后生理盐水100 ml+