鞍结节脑膜瘤伴视力障碍的显微手术治疗（附56例报告）  

Effect of microsurgical treatment in tuberculum sellae meningiomas associated with visual impairment （56 cases report）

作　　者：周辉[1] 贾桂军[1] 吴震[1] 耿素民[1] 王亮[1] 郝淑煜[1] 李达[1] 张力伟[1] 张俊廷[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科中心,100050

出　　处：《中华神经外科杂志》2012年第12期1222-1225,共4页Chinese Journal of Neurosurgery

基　　金：首都医学发展基金（2009-1040）;卫生部卫生公益性行业科研专项项目（200902004）;国家自然科学基金项目（81141028）

摘　　要：目的探讨显微手术治疗鞍结节脑膜瘤伴视力障碍的手术入路选择、手术技巧及临床疗效。方法回顾性分析56例手术治疗的鞍结节脑膜瘤伴视力障碍患者的临床资料，22例采用冠切单侧额下入路，28例经额底外侧入路，6例经额颞入路。结果肿瘤切除程度按Simpson分级：Ⅰ级切除22例，Ⅱ级切除28例，Ⅳ级切除6例。术后视力改善47例，无明显变化7例，2例恶化。无手术死亡。结论术前根据肿瘤的大小、生长方式及与重要结构的毗邻关系选择合适的手术入路，同时娴熟的显微外科手术操作技巧是取得良好临床疗效的关键。Objective To explore the microsurgical approaches, operative techniques, and clinical results of tuberculum sellae meningiomas associated with visual impairment. Methods An retrospective analysis was made on 56 patients, with tuberculum sellae meningiomas associated with visual impairment, between Jan 2008 and Jan 2012. These patients underwent microsurgery through a variety of surgical approaches, such as the coronal eraniotomy unilateral subfrontal approach （22 cases）, the frontal - lateral approach （28 cases）, and the frontal -temporal approach （6 cases）. Results According to the Simpson classification after resection, there were 22 cases of Simpson I , 28 cases of II , and 6 cases of IV. Visual impairment was improved in 47 cases, unchanged in 7, and worsened in 2. There was no case of death. Conclusions According to the size, location, growth pattern, and adjacent relationship to the important structures of these tumors, suitable surgical approaches should be selected for tuberculum sellae meningiomas before operation. The key point for good results is through the application of the skillful micro - neurosurgical technique.

关 键 词：脑膜瘤 鞍结节 视力障碍 显微外科手术 

分 类 号：R739.45[医药卫生—肿瘤]