显微神经外科手术切除加术后伽玛刀联合治疗窦汇区脑膜瘤  

Microneurosurgery combined with Gamma knife radiosurgery in treatment of confluens sinus meningiomas

作　　者：钟东[1] 唐文渊[1] 谭云[1] 陈贵杰[1] 

机构地区：[1]重庆医科大学附属第一医院神经外科,重庆400016

出　　处：《第三军医大学学报》2012年第12期1223-1225,共3页Journal of Third Military Medical University

摘　　要：目的探讨显微神经外科手术切除加术后伽玛刀联合治疗窦汇区脑膜瘤的有效性。方法回顾性分析2006-2011年15例经手术及病理证实的窦汇区脑膜瘤患者的临床资料。依据肿瘤基底附着部位和主体生长方向选择不同的手术入路,分别采用经枕下幕上入路、经幕上下联合入路及经幕下小脑上入路。结果 15例窦汇区脑膜瘤患者手术达SimpsonⅠ级切除者1例;手术达SimpsonⅡ级切除者2例;SimpsonⅢ～Ⅳ级切除者12例。所有患者手术顺利,术后恢复良好,无死亡病例。术后对未达SimpsonⅠ～Ⅱ级切除的12例患者行伽玛刀联合治疗,术后随访1～5年,无死亡病例,未见肿瘤复发。结论窦汇区脑膜瘤术后有残余肿瘤的患者联合伽玛刀治疗可有效降低窦汇区脑膜瘤术后复发率。Objective To evaluate the efficacy of microneurosurgery combined with Gamma knife radiosurgery in treatment of patients with confluens sinus meningiomas.Methods The clinical data including general information,method of treatment,and therapeutic effect of 15 patients with benign confluens sinus meningiomas treated by microneurosurgery and Gamma knife radiosurgery during 2006 to 2011 were retrospectively analyzed.The tumors were resected via different approaches and operative methods according to the position of tumor basement and the direction of tumor growth.Results According to Simpson＇s classification,Simpson Grade Ⅰ was achieved in 1 patient,Simpson Grade Ⅱ was achieved in 2 patients,and Simpson Grade Ⅲ to Ⅳ was achieved in 12 patients.The 12 patients who cannot achieve Simpson Grade Ⅰ to Ⅱ resection were given Gamma knife radiosurgery after operation.The 15 patients were followed up systematically for 1 to 5 years.The clinical conditions improved significantly in 13 patients and were stable in 2 patients with no recurrence.Conclusion For confluens sinus meningiomas,Gamma knife radiosurgery is proved to be an effective treatment for those patients with tumor residues after craniotomy,significantly reducing the recurrence rate.

关 键 词：窦汇区脑膜瘤 显微神经外科手术 伽玛刀 联合治疗 

分 类 号：R616[医药卫生—外科学] R651.11[医药卫生—临床医学]