显微手术切除蝶骨嵴大型脑膜瘤手术要点分析  

Technique analysis of microsurgical treatment of large and huge sphenoid wing meningiomas

作　　者：雷鹏[1] 王钰[1] 翁潮弟[1] 田立桩[1] 武弋[1] 周杰[1] 

机构地区：[1]兰州军区兰州总医院神经外科 全军脑肿瘤诊治中心,兰州730050

出　　处：《中华神经医学杂志》2008年第3期293-295,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨显微手术切除蝶骨嵴大型和巨大型脑膜瘤的手术要点。方法本组58例脑膜瘤患者经CT或MR检查确诊，其中采用颅眶颧或颅颧入路10例，采用改良翼点入路48例，均行显微手术切除肿瘤，3例发生颅内外沟通者于肿瘤切除后“三明治”法行颅底重建，3例患者的残余瘤体行X-刀治疗。结果本组肿瘤全切52例，大部切除6例，无死亡病例。术后神经功能明显改善者49例。随访6月～9．5年，8例有不同程度复发。结论根据肿瘤的生长方向选择恰当手术入路，采用显微手术分块切除肿瘤，强调术中注意对重要神经和血管进行保护，这些要点是提高手术效果的重要措施。Objective To investigate and evaluate the technique of microsurgery for the treatment of the large and huge meningiomas of the sphenoid wing. Methods Fifty-eight patients were finally diagnosed by CT and/or MR in this series. The sphenoid wing meningiomas were from 4 cm×3.5 cm×3.5 cm to 11 cm×10 cm×8 cm in volume, and were located at outside sphenoid wing in 28 and at the inner in 30, and were spherical in 53 and en plaque in 5. The microsurgery for resection of the tumors was done through a cranio-orbito-zygomatic or craniozygomatic approach in 10, and through a modified pterional approach in 48. Results Total resection was achieved in 52. No death occurred in the group. Follow-up of 6 months to 9.5 years showed obvious nervous function improvement in 49 and regrowth of the tumor in 8. Conclusions Based on the volume and development of the tumor, it is very important for improving therapeutic outcome to choose appropriate operative approach, get rid of the tumor piece by piece, and protect the nerves and vessels intmoperatively.

关 键 词：脑膜瘤 蝶骨嵴 显微外科手术 

分 类 号：R739.41[医药卫生—肿瘤]