Điều trị phẫu thuật cắt u màng não nền sọ trước bằng kỹ thuật mở nắp sọ lỗ khóa trên cung mày

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Văn Hệ Đồng, Văn Sơn Đồng, Đức Hạnh Văn

Ngôn ngữ: vie

Ký hiệu phân loại: 611.8137 Nervous system Sense organs

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý: 45296

Bộ sưu tập: Metadata

ID: 502298

Thêm vào giỏ

Đánh giá kết quả phẫu thuật u màng não nền sọ trước bằng tiếp cận lỗ khóa trên cung. Phương pháp: nghiên cứu hồi cứu hàng loạt ca lâm sàng u màng não được phẫu thuật lỗ khoá trên cung mày từ tháng 10/2020 đến 06/2022 tại Trung tâm Phẫu thuật Thần kinh - Bệnh viện Hữu nghị Việt Đức. Kết quả: Có 40 ca lâm sàng đã được phẫu, trong đó nữ giới chiếm ưu thế với 82,5% (33 bệnh nhân). Các biểu hiện lâm sàng chính là đau đầu 77,5%, nhìn mờ 47,5%, bán manh 25% và 2 bệnh nhân mất khứu. Kích thước trung bình của các khối u là 24,5 mm, thời gian phẫu thuật trung bình là 3 giờ. Khả năng cắt bỏ toàn bộ khối u là 85% (34 bệnh nhân), có 4 bệnh nhân (10%) cắt bỏ phần lớn khối u (>
90%) và có 2 trường hợp khối u cắt bỏ bán phần. Các biến chứng phổ biến trong mổ là dập não 10% (4 bệnh nhân) và tụ máu 10% (4 bệnh nhân), có 2 ca nhiễm trùng vết mổ sau phẫu thuật. Không có ca nào tử vong sau phẫu thuật, khả năng cải thiện thị giác là 84% (16/19 bệnh nhân có tổn thương thị giác trước mổ). Kết luận: Kinh nghiệm của chúng tôi cho thấy tiếp cận lỗ khoá trên cung mày cho phép cắt bỏ thành công các tổn thương u màng não, ít biến chứng, rút ngắn thời gian phẫu thuật và và hiệu quả thẩm mỹ tốt.To evaluate the surgical results of anterior cranial basal meningiomas by the keyhole eyebrow approach. Methods: A retrospective study of a series of clinical cases of meningiomas undergoing keyhole eyebrow surgery from October 2020 to June 2022 at the Center for Neurosurgery - Viet Duc Friendship Hospital. Results: There were 40 clinical cases operated, in which female predominates with 82.5% (33 patients). The main clinical manifestations were headache 77.5%, blurred vision 47.5%, hemianopia 25% and 2 patients anosmia. The mean size of the tumors was 24.5 mm, the mean operative time was 3 hours. The possibility of total tumor resection was 85% (34 patients), 4 patients (10%) had most of the tumor removed (>
90%) and there were 2 cases of partial resection. Common complications during surgery were brain contusion in 10% (4 patients) and hematoma in 10% (4 patients). There were 2 cases of postoperative wound infection. There were no deaths after surgery, the ability to improve vision was 84% (16/19 patients had visual damage before surgery). Conclusion: Our experience shows that the keyhole eyebrow approach allows successful resection of meningiomas, less complications, shorter surgery time and good esthetic effect.

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