【摘要】 目的 研究颅内肿瘤术后脑血管痉挛的发生情况,探讨颅内肿瘤术后脑血管痉挛的发病机制。方法 86例术前经颅多普勒超声仪(TCD)检查正常的颅内肿瘤病人均于术后进行连续TCD监测,观察病人术后脑血管痉挛的发生率、术后发生的时间以及持续时间,同时观察病人术后CT或MRI蛛网膜下腔出血的发生率和脑脊液中红细胞含量。结果86例病人术后脑血管痉挛的发生率为44.2％,发生时间平均为术后(1.9±0.9)d,持续时间平均为(10.7±1.8)d。与其它部位肿瘤比较,颅底肿瘤术后脑血管痉挛发生率较高,发生较早,持续时间较长,差别均有统计学意义。发生脑血管痉挛的病人术后CT或MRI检查蛛网膜下腔出血的发生率和脑脊液红细胞含量均明显高于未发生脑血管痉挛的病人,差别均有显著性。结论 颅内肿瘤术后脑血管痉挛相当多见,尤其颅底肿瘤术后脑血管痉挛发生率较高且出现时间较早、持续时间较长。蛛网膜下腔积血特别是脑底池积血以及手术操作对动脉壁的机械性损害是造成颅内肿瘤术后脑血管痉挛的主要原因。更多还原

【Abstract】 Objective To study cerebral vasospasm in patients with intracranial tumor removed and to explore its pathogenesis. Methods 86 patients, whose preoperative transcranial Doppler ultrasonography(TCD) checking results were normal, took the continuous TCD monitoring after the removal of intracranial tumors to observe the incidence, onset time and duration of cerebral vasospasm. In addition, the incidence of subarachnoid hemorrhage (SAH) was observed with CT or MRI and the red blood cells in cerebrospinal fluid were counted in the 86 patients. Results The incidence, onset time and average duration of cerebral vasospasm in the 86 patients were 44.2%, (1.9±0.9) d and (10.7±1.8) d respectively. Compared with other tumor locations, the patients with tumors on the skull base suffered higher incidence, earlier onset time and longer duration of cerebral vasospasm, and the differences were statistically significant. The incidence of SAH detected with CT or MRI was statistically higher in patients with vasospasm than that in ones without vasospasm, so is the content of red blood cells in cerebrospinal fluid. Conclusion Cerebral vasospasm following the removal of intracranial tumors is quite common, especially in patients with tumors on skull base, who have higher incidence, earlier onset time and longer duration. SAH, in particular blood accumulation in the basal cistern, and mechanical injury of cerebral arteries resulting from surgical procedure are primary reasons leading to cerebral vasospasm after the removal of intracranial tumors.更多还原