摘要
目的探讨脑膜中动脉(MMA)栓塞治疗慢性硬膜下血肿(CSDH)的疗效。方法回顾性分析济宁市第一人民医院神经外科2022年4月至2024年12月通过MMA栓塞治疗的40例CSDH患者的临床资料,术后观察患者临床症状和并发症,并通过CT和(或)MRI检查确定血肿吸收情况。结果40例(48例侧)患者手术均顺利完成,2例侧血肿因出血量少采取保守治疗。术后35例患者影像学复查可见血肿逐渐吸收,且患者症状消失,其主要症状明显好转时间[M(Q_(1),Q_(3))]为22.5(7.0,30.0)d。术后23例患者获得影像学随访,随访时间[M(Q_(1),Q_(3))]为90(64,130)d,可见患者血肿均完全吸收。术后5例患者因临床症状加重接受了钻孔引流手术治疗。并发症方面,1例患者术后患侧永久失明;1例患者术后出现外展神经功能障碍,但于术后40 d恢复正常;其他患者均无围手术期严重并发症。结论MMA栓塞是CSDH的有效治疗措施,值得临床推广应用。
Objective To explore the efficacy of middle meningeal artery(MMA)embolization in the treatment of chronic subdural hematoma(CSDH).Methods The clinical data of 40 patients with CSDH who were treated by embolization of MMA in the Department of Neurosurgery,Jining No.1 People's Hospital from April 2022 to December 2024 were retrospectively analyzed.The clinical symptoms and complications of the patients were observed after the operation,and the hematoma absorption was determined through CT and/or MRI examination.Results The surgeries of 40 patients(48 on the side)were all successfully completed.Conservative treatment was adopted for 2 cases of side hematoma due to the small amount of bleeding.The imaging reexamination of 35 patients after the operation showed that the hematoma gradually absorbed,and the clinical manifestations of the patients returned to normal.The time[M(Q_(1),Q_(3))]for significant improvement of the main symptoms was 22.5(7.0,30.0)days.Imaging follow-up was obtained for 23 patients after the operation.The follow-up time[M(Q_(1),Q_(3))]was 90(64,130)days and it could be seen that the hematoma of all patients was completely absorbed.After the operation,5 patients underwent drilling and drainage surgery due to aggravated clinical symptoms.In terms of complications,one patient suffered permanent blindness on the affected side after the operation.One patient presented with abducens nerve dysfunction after the operation,but returned to normal 40 days after the operation.The other patients had no serious perioperative complications.Conclusion MMA embolization is an effective treatment measure for CSDH and is worthy of clinical promotion and application.
作者
赵峰
苏春海
胡顺鑫
刘军
张峰
冯雷
Zhao Feng;Su Chunhai;Hu Shunxin;Liu Jun;Zhang Feng;Feng Lei(Department of Neurosurgery,Jining No.1 People's Hospital,Jining 272000,China;Shandong Provincial Key Medical and Health Laboratory of Neuroinjury and Repair,Jining 272000,China)
出处
《中华神经外科杂志》
北大核心
2025年第6期617-620,共4页
Chinese Journal of Neurosurgery
基金
济宁市重点研发计划(2022YXNS137)。
关键词
血肿
硬膜下
慢性
栓塞
治疗性
脑膜中动脉
血管内操作
治疗效果
Hematoma,subdural,chronic
Embolization,therapeutic
Middle meningeal artery
Endovascular procedures
Treatment outcome
