36例颅内巨大脑膜瘤的显微手术治疗  

Microsurgical Treatment of 36 Cases of Giant Intracranial Meningiomas

作　　者：岳景齐 钟志坚 孙海鹰 王建荣 

机构地区：[1]邵阳市中心医院,湖南邵阳422000

出　　处：《中外医学研究》2013年第17期7-8,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨颅内巨大脑膜瘤的显微手术治疗效果。方法:本次研究选择的对象均为笔者所在医院2007年6月-2012年9月收治的颅内巨大脑膜瘤患者,其中36例采用显微手术治疗,20例行传统开颅手术治疗,两组比较,回顾相关临床资料。结果:显微手术组36例患者中,脑膜瘤SimpsonⅠ级切除15例,Ⅱ级13例,Ⅲ级7例,Ⅳ级1例。与术前比较,临床症状均有改善,术后出现一过性失语、偏瘫5例,经积极治疗,3个月后恢复。常规对SimpsonⅢ级、Ⅳ级者行放射治疗。常规手术组一过性失语、偏瘫12例,与显微手术组比较差异有统计学意义(P<0.05)。结论:对于颅内巨大脑膜瘤的手术治疗,术前加强DSA检查、MRI及CT检查;术中做好重要脑组织、神经、血管的保护,提高操作技巧,早期对肿瘤血供加以阻断,粘连部位行锐性分离操作,确切止血,行瘤内分块切除;术后加强并发症的防护,积极采取预防措施,可提高手术质量,降低患者致残率和致死率。Objective： Explore the giant intraeranial meningiomas mierosurgical treatment.Methods： Patients with giant intracranial meningiomas object of this study selected were admitted to hospital from June 2007 to September 2012, 36 cases using mierosurgical treatment. with traditional craniotomy treatment, compare 2 group, review the related clinical data.Results： The mierosurgery group of 36 patients, 15 eases Meningioma Simpson grade Ⅰ resection, 13 eases of grade Ⅱ , 7 cases in grade Ⅲ, 1 cases of grade Ⅳ.Clinical symptoms were improved compared with the preoperative, postoperative transient aphasia, hemiplegia 5 cases, aggressive treatment, three months after recovery.Simpson Ⅲ 、 Ⅳ grade with Conventional raditherapy. Conventional surgery group had aphasia, hemiplegia, 12 cases, compared with the microsurgical group difference was statistically significant （P 〈0.05）.Conclusion： For the treatment of giant intracranial meningioma operation, preoperative enhanced DSA examination, MRI and CT.The intraoperative do a good job of important brain tissue, nerves, blood vessels protection, enhance skills, early for them to block the tumor blood, the adhesions parts line the sharp separation operation, exact hemostasis line intratumoral block resection.The postoperative strengthen protection of complications, actively take preventive measures, can improve surgery quality, reduce patient morbidity andmortality.

关 键 词：颅内肿瘤 巨大脑膜瘤 显微手术 

分 类 号：R739.45[医药卫生—肿瘤]