蝶骨嵴内1/3脑膜瘤的超声刀显微神经外科治疗  

Microneurosurgical treatment of meningioma in the inner 1/3 part of crista sphenoidalis with CUSA

作　　者：郭振宇 师蔚[1] 张新文 

机构地区：[1]西安交通大学医学院第二附属医院神经外科,西安710004 [2]陕西省富平县医院外科,711700

出　　处：《中华神经医学杂志》2006年第8期837-839,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨超声刀显微神经外科治疗蝶骨嵴内1/3脑膜瘤手术技巧和治疗效果。方法对比分析1998～2005年间采用超声刀显微神经外科治疗39例蝶骨嵴内1/3脑膜瘤和1998年前应用传统显微外科手术治疗同一部位、同一类型肿瘤35例临床资料。结果本组39例中,肿瘤全切除32例,次全切除7例。术后颅高压症状消失16例,减轻6例；视力障碍缓解10例；面部麻木感减轻1例(病灶侧),眼睑下垂好转1例。术后CT随访半年至5年,肿瘤全切除32例中未见肿瘤复发,次全切除7例(1例死亡)中肿瘤复发1例。结论超声刀显微神经外科切除蝶骨嵴内1/3脑膜瘤是较为安全可靠的手术方法,肿瘤能否全切除关键取决于肿瘤与周围组织的粘连程度、大小及质地等情况。Objective To investigate the operative techniques and curative effect of microneurosurgery with cavitron ultrasound surgical aspirator （CUSA） in the treatment of meningioma in the inner 1/3 part of crista sphenoidalis. Methods The 39 patients with meningioma in the inner 1/3 part of crista sphenoidalis treated with CUSA during 1998-2005 and the 35 patients with meningioma at the same place treated with conventional microsurgery before 1998 in our hospital were compared and analyzed in the therapeutic outcomes. Results Of the 39 cases, total removal was achieved in 32 cases, subtotal removal in 7 cases, including 1 case deceased. In 28 cases with preoperative intracranial hypertension, 16 cases were corrected and 6 improved; in 22 cases with visual disorder, 10 cases were amended. Numbness occurred in 1 case and disappeared after operation. In 2 cases with preoperative ptosis, 1 case got better. In the 38 cases （apart from the deceased cases） undergoing CT during 0.5-5 year follow-up, the tumors did not recur in 32 cases with total removal, but 1 case recurred in 7 cases of subtotal removal. Conclusion Microneurosurgery with CUSA in the treatment of meningioma in the inner 1/3 part of crista sphenoidalis is a safe and reliable method, but the extent of removal depends on the adhesive degree of the tumors to the surrounding tissues, the size and nature of the tumors.

关 键 词：脑膜瘤 蝶骨嵴 超声刀 显微神经外科手术 

分 类 号：R739.4[医药卫生—肿瘤]