前床突脑膜瘤的显微手术治疗探讨  

Microsurgical management of anterior clinoidal meningiomas

作　　者：崔华[1] 王勇[1] 周正文[1] 费智敏[1] 书国伟[1] 殷玉华[1] 樊翊凌[1] 张珏[1] 周彩芳[1] 李善泉[1] 刘洪章 丁毅 

机构地区：[1]上海交通大学医学院附属仁济医院神经外科,上海200001 [2]贵州省六盘水市人民医院神经外科

出　　处：《中华神经外科杂志》2007年第9期650-652,共3页Chinese Journal of Neurosurgery

基　　金：上海市科委课题(064119509);上海市卫生局科研课题(044047)

摘　　要：目的探讨采用显微手术治疗前床突脑膜瘤的方法和疗效。方法对1999至2006年收治的26例前床突脑膜瘤进行回顾性分析。其中,男8例,女18例,年龄为21～66岁,平均47.6岁。本组患者采用翼点入路或扩大翼点入路,术中辅以微血管多普勒技术指导肿瘤包裹血管的分离。结果26例患者中,SimpsonⅣ级切除6例,SimpsonⅢ级切除4例,SimpsonⅡ级切除16例,无死亡病例。结论利用显微手术可明显提高肿瘤全切除率,减少术后并发症,降低死亡率;对于明显侵犯海绵窦和颈内动脉等重要结构的残余肿瘤,可考虑术后放射治疗。Objective To explore the method and therapeutic effectiveness of microsurgery for clinoidal meningiomas. Methods The clinical data of 26 patients with clinoidal meningiomas treated from 1999-2006 were analyzed retrospectively. There were 8 men and 18 women. The patients ranged in age from 21 to 66 years （mean 47. 6 years）. All patients underwent surgery through the pterional or extended pterional approach. Microvascular Doppler probe was used to guide dissection of the tumor from internal carotid artery（ICA） and its branching arteries, Results Resection were achieved in 6 cases （23.1% ） in Simpson grade Ⅳ, in 4 cases（ 15.4% ） in Simpson grade Ⅲ, in 16 cases （61.5%） in Simpson grade Ⅱ. No patients died. Conclusions The microsurgery can be a great help in total resection of the tumors, and reduce the postoperative complications and mortality. Combined operations with postoperative radiotherapy should be carried out for treating the tumor remained apparently invading tissues such as the cavernous sinus or ICA.

关 键 词：前床突脑膜瘤 显微手术 微血管多普勒 

分 类 号：R739.45[医药卫生—肿瘤]