鞍旁脑膜瘤显微手术疗效及远期复发分析  

Microsurgery for parasellar menningiomas and impact factors of recurrence

作　　者：袁盾[1] 刘定阳[1] 袁贤瑞[1] 姜维喜[1] 罗端午[1] 刘庆[1] 彭泽峰[1] 丁锡平[1] 杨治权[1] 

机构地区：[1]中南大学湘雅医院神经外科,长沙410008

出　　处：《中南大学学报（医学版）》2013年第7期699-703,共5页Journal of Central South University ：Medical Science

摘　　要：目的:研究鞍旁脑膜瘤显微手术疗效,分析肿瘤复发影响因素。方法:回顾性分析经显微手术治疗的134例鞍旁脑膜瘤临床及病理资料。结果:肿瘤全切除(Simpson Ⅰ级、Ⅱ级)109例(81.3%),随访病例116例,平均随访时间81.6个月,患者平均生活质量评分(KPS)91.9分,其中优秀90例,良好16例。动眼神经功能障碍6例,三叉神经功能障碍7例,癫痫8例,轻偏瘫9例。96例肿瘤全切除患者中复发12例,复发率12.5%。20例未全切除病例中12例(60%)肿瘤不同程度进展。肿瘤侵犯海绵窦复发率明显高于无海绵窦侵犯患者(P=0.043),肿瘤病理级别越高,复发风险越大(P<0.01)。结论:鞍旁脑膜瘤显微手术治疗能获得良好的远期疗效,手术全切除是首选治疗方法,肿瘤侵犯海绵窦术后需要密切随访,非典型脑膜瘤及间变型脑膜瘤复发风险大,建议术后常规放射治疗。Objective： To study the effect of microsurgery for parasellar menningiomas and to analyze the impact factors of recurrence. Methods： Clinical and follow-up data in a consecutive series of 134 patients with parasellar meningiomas were retrospectively analyzed. Results： A total of 109 patients （81.3%） had radical removal （Simpson grade Ⅰ and Ⅱ）, and 116 patients were followed up for an average period of 81.6 months. The mean quality of life score （KPS） was 91.9, 90 patients regained full daily activity and 16 patients were able to take care of themselves. Oculomotor paralysis occurred in 7 patients, epilepsy in 8, and another 9 patients suffered hemispheral up patients （12.5%）. （60%）. Tumor with paralysis. Tumor recurred after the radical removal in 12 out of the 96 follow- Tumor p caverno rogressed after subtotal removal in 12 out of the 20 follow-up patients us sinus （CS） invasion had significantly higher risk of recurrencecampared with non-CS invasion （P=0.043）. The recurrence rate increased with the pathological grade （P〈 0.01）. Conclusion： Patients with parasellar meningiomas undergoing microsurgical resection may have a good long-term function outcome. For most patients, total removal by microsurgery is the first choice. Careful follow-up is needed if tumor invaded the CS and radiosurgery is proposed for WHO grade i and 2.

关 键 词：鞍旁脑膜瘤 显微手术 肿瘤复发 

分 类 号：R739.4[医药卫生—肿瘤]