鞍结节脑膜瘤42例临床分析  

Clinical study on 42 cases meningiomas of the tuberculum sellae

作　　者：张良文[1] 朱树干[1] 吴承远[1] 焦力群[1] 魏东光[1] 见文成[1] 

机构地区：[1]山东大学齐鲁医院神经外科,济南250012

出　　处：《中国神经精神疾病杂志》2001年第6期413-414,共2页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的 探讨鞍结节脑膜瘤的诊断及治疗。方法 对４２例鞍结节脑膜瘤的临床资料进行回顾性分析。结果 肿瘤全切除２８例，次全切除９例，部分切除５例，其中颅底重建５例。术后５５％病人视力改善，大部分病人恢复正常工作。结论 对首发症状为视力视野改变特别是伴持续性头痛者，应行ＣＴ或ＭＲＩ检查，争取早期确诊：肿瘤形状及生长方向是影响肿瘤切除的主要因素，应肿瘤的大小及生长方向确定手术入路；细致的显微手术可以避免损伤鞍区的重要结构，对有颅底骨质破坏者需行颅底重建；应对鞍结节脑膜瘤进行细致分型，从而更有利于手术及估计预后。Objective To study the diagnosis and treatment of meningiomas of the tuberculum sellae. Methods Retrospec- tive analysis of the clinical materials of 42 patients who were treated in our hospital from 1991-2000. Results We performed total removal in 28 patients subtotal removal in 9 patients and partial removal 5 patients. Reconstruction of the skull base was required in 5 patients. 53 percent had visual improvement, most of which returned to normal work. Conclusions In patients with impar- imed visual acuity and defect in visual fields as the presenting symptom, particularly those with persistent headache, CT or MRI ex- amination is needed. Operative approach may partly depend on the ske and growth direction of the minor while the shape and growth direction of the tumor determine the degree of resection. Careful microsurgical surgery is required to avoid damage to the im- portant structures locateded in the sella region. Reconstruction of the skull base is needed in patients with bone destruction. A more detailed classification of the meningiomas in the tuberculum sellae is needed to guide operation apporach and to predict prognosis

关 键 词：鞍结节脑膜瘤 外科手术 诊断 治疗 病例分析 手术方法 

分 类 号：R739.4[医药卫生—肿瘤]