摘要
目的 :报道我科 1994年 1月至 1997年 12月经乙状窦后进路手术 6 5岁以上患者 6 8例 ,讨论了各种异常对手术的可能影响及围术期相关问题的处理。方法 :手术治疗的疾病有 :原发性三叉神经痛 5 2例 ,桥小脑角胆脂瘤 3例 ,听神经瘤 1例 ,半面痉挛 12例。术前检查异常的有 :心电图 2 9例 ,占 42 .6 5 % ;胸部放射线检查异常 11例 ,占 16 .18% ;高血脂 3例 ,占 4.4% ;糖尿病 1例 ,占 1.47% ;高血压病 8例 ,占 11.76 % ;白细胞低下 2例 ,占 2 .94% ;血小板减少 1例 ,占1.47% ;腹部 B超 9例 ,占 13.2 4% ;神经性耳聋 9例。结果 :所有患者顺利完成手术 ,随访 8个月至 5年 ,症状无复发。术后并发症 :颅内感染 2例 ,迟发性小脑血肿 1例 ,应激性溃疡 1例。均治愈出院。结论 :认为老年患者虽然体质较差 ,体检结果异常多 ,但只要正确处理围手术期的异常 ,老年患者完全可以耐受耳神经外科手术。
Objective: Sixty eight patients of over 65 years old undergone the microsurgical operations by retrosigmoidal sinus approach in our department were reported to discuss the possible effect of various preoperative abnomalities on the operation and the management of interrelated questions during operative period. Methods: The patients were made up of 52 cases of idiopathic trigeminal neuralgia, 3 of cerebellopontine angle cholesteatoma, 1 of acoustic neuroma and 12 of hemifacial spasm. Among the abnomalities of preoperative examinations, Electrocardiogram was presented in 9 cases (42.65%), thoracic x\|ray in 11 (16.8%), hyperlipemia in 3 (4.40%), diabetes in 1 (1.47%), hypertension in 8 (11 76%), leukopenia in 2 (2.94%), thrombocytopenia in 1 (1.47%), abdominal B\|type ultrasound in 9 (13.24%) and neural deafness in 9. Results: All patients were successfully operated. Symptoms were no recurrence during the follow\|up 9 months to 5 years.The complications after the operations included 2 cases of intracranial infection, 1 of delayed cerebellar hematoma, 1 of stress ulcer which were cured and discharged. Conclusions: Although the ageing patients were in poor health and presented more abnomalities of preoperative examinations, they could fully bear the otoneurosurgical operation as long as the abnomalities during operative period were correctly handled.
出处
《耳鼻咽喉（头颈外科）》
2001年第4期199-201,共3页
Chinese Arch Otolaryngology-Head Neck Surg
