郁军超,于秋红,刘亚玲,薛连璧
YU Junchao,YU Qiuhong,LIU Yaling,XUE Lianbi

• 1:首都医科大学附属北京天坛医院

摘要(Abstract)：

目的:探讨高压氧对脑膜瘤术后患者的治疗效果。方法:100例脑膜瘤手术切除患者,术后分为常规治疗组和高压氧治疗组,两组患者均给予常规治疗,高压氧组在常规治疗的基础上再给予高压氧治疗,比较两组患者治疗前后神经功能评分(NIHSS)评价神经功能障碍程度及颅脑影像学检查脑水肿体积变化。结果:脑膜瘤切除术后,常规治疗组和高压氧治疗组患者间NIHSS评分无显著差异(t=0.631,P=0.530),治疗后,两组患者NIHSS评分均明显降低,但高压氧组患者NIHSS减少量高于常规组,差异有统计学意义(t=2.147,P=0.034);治疗前,两组患者脑水肿体积间差异无统计学意义(t=0.368,P=0.714),治疗后,两组患者脑水肿体积均明显减小,但高压氧组患者脑水肿体积减少量高于常规组,差异有统计学意义(t=2.276,P=0.025)。结论:高压氧治疗能够有效减轻脑膜瘤术后患者的脑水肿,改善神经功能障碍,促进神经功能恢复。
Objective: To investigate the efficacy of hyperbaric oxygen( HBO) treatment on meningioma patients after surgery. Methods: One hundred meningioma patients after surgery were divided into two groups,the control group and HBO group. Patients in both groups were given routine treatment,and patients in HBO group additionally underwent HBO treatment. NIHSS score data and volumetric changes of the brain edema from both groups were collected before and after treatment for comparison.Results: There was no difference in NIHSS score between the two groups after surgery( t = 0. 631,P =0. 530),NIHSS score notably reduced in both groups after treatment. NIHSS score reduced more in HBO group than the control group( t = 2. 147,P = 0. 034). There was no difference in volume of brain edema before surgery between the two groups( t = 0. 368,P = 0. 714),brain edema notably reduced in both groups after treatment. The volume of brain edema in HBO group reduced more than the control group( t = 2. 276,P = 0. 025). Conclusion: HBO treatment can reduce brain edema and neurological dysfunction caused by meningioma after surgery.

关键词(KeyWords)： 脑膜瘤;功能恢复;脑水肿;高压氧
meningioma;function recovery;brain edema;hyperbaric oxygen

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(No.30972829)

作者(Author): 郁军超,于秋红,刘亚玲,薛连璧
YU Junchao,YU Qiuhong,LIU Yaling,XUE Lianbi

DOI: 10.19367/j.cnki.1000-2707.2015.12.027

参考文献(References)：

• [1]Wiemels J,Wrensch M,Claus EB.Epidemiology and etiology of meningioma[J].J Neurooncol,2010(3):307-314.
• [2]Cornelius JF,Slotty PJ,Steiger HJ,et al.Malignant potential of skull base versus non-skull base meningiomas:clinical series of 1,663 cases[J].Acta Neurochir(Wien),2013(3):407-413.
• [3]Yongjun L,Xin L,Qiu S,et al.Imaging findings and clinical features of intracal lymphoplasmacyte-rich meningioma[J].J Craniofac Surg,2015(2):132-137.
• [4]Meskal I,Gehring K,van der Linden SD,et al.Cognitive improvement in meningioma patients after surgery:clinical relevance of computerized testing[J].J Neurooncol,2015(3):617-625.
• [5]Mahore A,Ramdasi R.Meningioma of foramen magnum causing drop attacks[J].Case Rep Neurol Med,2015(2):214.
• [6]Osawa T,Tosaka M,Nagaishi M,et al.Factors affecting peritumoral brain edema in meningioma:special histological subtypes with prominently extensive edema[J].J Neurooncol,2013(1):49-57.
• [7]Oyama H,Kito A,Maki H,et al.Surgical results of parasagittal and falx meningioma[J].Nagoya J Med Sci,2012(1-2):211,216.
• [8]Johnson WD,Loredo LN,Slater JD.Surgery and radiotherapy:complementary tools in the management of benign intracranial tumors[J].Neurosurg Focus,2008(5):E2.
• [9]崔永胜,康全利.高压氧在脑弥漫性轴索损伤治疗中的作用.贵阳医学院学报,2010(5):487-488.
• [10]Miller RS,Weaver LK,Bahraini N,et al.Effects of hyperbaric oxygen on symptoms and quality of life among service members with persistent postconcussion symptoms:a randomized clinical trial[J].JAMA Intern Med,2015(1):43-52.
• [11]Sughrue ME,Rutkowski MJ,Aranda D,et al.Factors affecting outcome following treatment of patients with cavernous sinus meningiomas[J].J Neurosurg,2010(5):1087-1092.
• [12]Ouyang T,Zhang N,Wang L,et al.Sphenoid wing meningiomas:Surgical strategies and evaluation of prognostic factors influencing clinical outcomes[J].Clin Neurol Neurosurg,2015(134):85-90.
• [13]唐晓平,张涛,彭华,等.瘤周水肿明显的脑膜瘤术后高压氧治疗[J].中华神经外科杂志,2010(2):138-141.
• [14]Oszvald A,Quick J,Franz K,et al.Resection of gliomas in the cingulate gyrus:functional outcome and survival[J].J Neurooncol,2012(2):341-348.
• [15]Chen X,Duan XS,Xu LJ,et al.Interleukin-10 mediates the neuroprotection of hyperbaric oxygen therapy against traumatic brain injury in mice[J].Neuroscience,2014(266):235-243.
• [16]Wee HY,Lim SW,Chio CC,et al.Hyperbaric oxygen effects on neuronal apoptosis associations in a traumatic brain injury rat model[J].J Surg Res,2015(2):382-389.

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