神经导航辅助显微手术治疗大脑皮质中央区脑膜瘤  

Microsurgical treatment for meningioma in the central cortex area guided by neuronavigation

作　　者：凌士营[1] 王林[1] 傅先明[1] 牛朝诗[1] 蒋辰[1] 丁宛海[1] 汪业汉[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科,合肥230001

出　　处：《中国微侵袭神经外科杂志》2011年第8期348-350,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的总结神经导航辅助显微技术切除大脑皮质中央区脑膜瘤的手术经验。方法回顾性分析29例大脑皮质中央区脑膜瘤病人的临床资料,术中导航辅助确定肿瘤切除范围,利用肿瘤与脑组织之间的蛛网膜界面,整体或分块切除肿瘤,注意保护肿瘤周围重要组织。结果按照Simpson分级标准:Ⅰ级切除17例(58.6%),Ⅱ级切除9例(31.0%),Ⅲ级切除3例(10.4%)。无手术死亡。随访21例,时间3个月～4年,Ⅱ级切除1例、Ⅲ级切除2例在术后1～3年复发。结论术前影像学评估,术中应用神经导航辅助显微外科技术切除大脑中央区皮质脑膜瘤,妥善保护大脑中央区血管、脑皮质、矢状窦,是提高大脑中央区皮质脑膜瘤手术疗效、降低手术并发症的重要因素。Objective To summarize the experiences with microsurgical treatment of meningioma in the central cortex area guided by neuronavigation.Methods The clinical data of 29 patients with meningioma in the central cortex area were analyzed retrospectively.The resection range was determined by assistance of navigation during operation.The tumors were removed en bloc or piece by piece through arachnoid interface between the tumor and brain tissues,and the important tissues around the tumors should be protected.Results Simpson gradeⅠremoval of the tumors was accomplished in 17 cases（58.6%）,Simpson grade Ⅱ removal in 9（31.0%） and Simpson grade Ⅲremoval in 3（10.4%）.No patients died.Twenty-one patients were followed up for 3 months to 4 years.Meningioma reoccurred in 3 patients 1 to 3 years after operation,including Simpson gradeⅡremoval in 1 and Simpson grade Ⅲ removal in 2.Conclusions Preoperative imaging evaluation,using microsurgical technology guided by neuronavigation intraoperatively to remove meningioma in the central cortex area and proper protection of the vessels,cortex and sagittal sinus in the central area of brain are important factors for improving therapeutic efficacy and decreasing the complication rates of meningioma in the central cortex area.

关 键 词：脑膜瘤 中央区 大脑皮质 神经导航 显微外科手术 

分 类 号：R739.45[医药卫生—肿瘤]