【摘要】 目的分析大型脑膜瘤术后易再次出血形成血肿的原因,探讨颅内静脉系统保护的意义。方法回顾性总结分析我院自2000年5月至2008年5月收治的356例巨大脑膜瘤患者的临床资料。肿瘤直径为5.8～12cm。结果32例患者术后头颅CT示瘤腔内不同程度渗血或出血,可见条索状,三角状和圆形高密度影。13例行MRI检查示脑皮质肿胀,脑实质内血肿。23例行去骨瓣减压术。死亡2例。3例生活不能完全自理。结论本资料提示术中颅内静脉损伤可能是脑膜瘤术后出血的主要原因。术中妥善保护好静脉,避免损伤,精巧的显微手术技巧,可减少术后血肿发生率。更多还原

【Abstract】 Objective To analyze the cause of the intracranial hematomas after the microsurgery for the large meningioma in order to emphasize the significance of intracranial venous system protection during the operation. Methods The clinical data of 356 patients with large meningiomas, who underwent microsurgery from May, 2000 to May, 2008, were analyzed retrospectively. The diameter of the tumors were ranged from 5.8 to 12 cm. Results The postoperative head CT examination showed that there was bleeding to different extent, which manifested cord-like, triangular-shaped and circular high-density shadow, in the timorous cavities of 32 patients. The postoperative head MRI examination showed swelling of the cerebral cortexes and intracereral hematomas in 13 patients. The decompressive craniectomy was performed in 23 patients. Two patients died, and 3 patients could not completely take care of themselves in the living. Conclusions It is suggested that the injury of the intracerebral veins during the microsurgery may be main cause of the bleeding after the operation for the large mengiomas. The incidence of the postoperative intracranial hematomas may be reduced by the skillful microsurgical technique and the good protection of the intracerebral veins in the patients with large mengiomas.更多还原