前颅底大型脑膜瘤的显微手术治疗  

Microsurgical treatment for large meningiomas at anterior skull base

作　　者：王飞[1] 潘庆刚[1] 刘宁涛[1] 海舰[1] 沈峰[1] 邓东风[1] 

机构地区：[1]同济大学附属同济医院神经外科,上海200065

出　　处：《同济大学学报（医学版）》2008年第3期71-74,共4页Journal of Tongji University(Medical Science)

摘　　要：目的探讨前颅底大型脑膜瘤的手术入路、显微手术方法和治疗效果。方法对显微手术治疗的21例前颅底大型脑膜瘤患者的影像学资料、手术入路、显微手术切除肿瘤的方法及疗效进行回顾性分析。结果按照Simpson切除标准,本组21例中,Ⅰ级切除16例（76.19%）;Ⅱ级切除3例（14.29%）;Ⅳ级切除2例即行脑膜瘤次全切除（9.52%）。肿瘤全切除90.48%,次全切除9.52%。无手术死亡,随访6-24个月,无复发。结论充分的术前影像学检查及评估,采用显微手术切除前颅底大型脑膜瘤,术中保护重要神经与血管、处理好受累的颅底骨质和脑膜,能明显提高肿瘤的全切除率,减少并发症,提高临床疗效。Objective To investigate the operative approaches, microsurgical technique and its curative effect for large meningiomas at anterior skull base. Methods Clinical data including imaging data, the operative approach, microsurgery methods and curative effect of 21 patients with large meningiomas at anterior skull base who underwent microsurgical surgery in our hospital from January 1998 to June 2005 were analyzed retrospectively. Results According to Simpson classification of glioma resection, 16 received Grade Ⅰ resection （76.19%）, 3 received Grade Ⅱ resection（ 14.29% ） and 2 received Grade Ⅳ resection（9.52% ） in all 21 patients. No patients died from the operation. Following-up 6 to 24 months showed that none recurred. Conclusion The large meningiomas at anterior skull base can be totally resected by using microsurgical techniques. The measurments including sufficient preoperative imaging evaluation, good protection of the nerve and blood vessel, excellent management of the affected bone of skull base and meninges during the operations. It can significantly increase the percentage of total removal of the large meningiomas at anterior skull base, decrease postoperative complications, and improve survival outcome.

关 键 词：前颅底 脑膜瘤 显微手术 

分 类 号：R730.264[医药卫生—肿瘤]