颈静脉孔区脑膜瘤显微外科治疗  

Microsurgical treatment for jugular foramen meningionms

作　　者：黄冠又[1] 张俊廷[1] 吴震[1] 张岩[1] 郝淑煜[1] 张力伟[1] 贾桂军[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050

出　　处：《中华医学杂志》2012年第41期2921-2923,共3页National Medical Journal of China

基　　金：首都医学发展科研基金（2009.1040）;卫生部公益性行业科研专项基金（200902004）

摘　　要：目的探讨颈静脉孔区脑膜瘤的显微外科手术治疗方法和临床疗效。方法回顾性分析了1996年4月至2011年4月北京天坛医院28例行显微外科手术切除的颈静脉孔区脑膜瘤患者，依据分型采用枕下乙状窦后人路13例，远外侧入路9例，耳后“C”形经髁上人路4例、经髁旁人路2例。结果肿瘤全切除18例，次全切除10例，本组22例得到随访，随访时间平均3年。19例随访KPS评分在80分以上，12例仍有不同程度的声嘶或呛咳症状，11例生活可自理，2例死于肿瘤复发。结论颈静脉孔区脑膜瘤有较高复发率，术后出现后组颅神经功能损伤发生率较高。根据不同分型的肿瘤选择合适的手术入路可取得较好的治疗效果。Objective To explore the microsurgical treatment and clinical efficacies of jugular foramen meningiomas. Methods A total of 28 patients with jugular foramen meningiomas undergoing microsurgieal operations at Beijing Tiantan Hospital during the period from April 1996 to April 2011 were analyzed retrospectively. The retrosigmoid suboeeipital （ n = 13 ）, far lateral （ n = 9 ）, postauricular trans- supracondylar （ n = 4 ） and trans-paracondylar approaches （ n = 2 ） were used. Results Complete tumor resection was achieved in 18 patients and subtotal tumor resection in I0 patients. Twenty-two patients were followed up for a mean follow-up period of 3 years. The postoperative Karnofsky performance scale was above 80 in 19 patients. Twelve patients experienced hoarseness or bucking, 11 lived independently and 2 died of tumor recurrence. Conclusion Jugular foramen meningiomas have a higher recurrence rate and severe cranial nerve damages may occur postoperatively. It is important to classify them into different clinical entities and choose appropriate surgical approaches and techniques so as to achieve satisfactory outcomes.

关 键 词：脑膜瘤 颅底 显微外科手术 

分 类 号：R739.45[医药卫生—肿瘤]