脑膜瘤的显微外科手术治疗(附58例报告)  

Microsurgical treatment of meningiomas--attached 58 cases of report

作　　者：李相龙[1] 孙京和[1] 赵春植[1] 王延国[1] 金永寿[1] 金光石[1] 韩东汉[1] 任光旭[1] 玄汉石[1] 

机构地区：[1]延边大学医学院附属医院神经外科,吉林延吉133000

出　　处：《延边大学医学学报》2002年第1期61-64,共4页Journal of Medical Science Yanbian University

摘　　要：[背景 ]总结分析脑膜瘤的手术入路和显微外科手术效果 ,探讨如何提高全切率、降低手术死残率、改善手术效果 .[病例报告 ]回顾性分析自 1997年 11月至 2 0 0 1年 9月间的 5 8例脑膜瘤病例 ,采用 6种手术入路行显微外科手术治疗 ,包括翼点入路 4例 ,经额下入路 2例 ,跨矢状线入路 2 4例 ,乳突后枕下入路 5例 ,枕下正中 寰椎入路 2例 ,按肿瘤部位入路 2 1例 .5 8例病人中切除脑膜瘤共 61个 ,术后CT复查示全切 5 2例 ( 90 % ) ,次全切除 2例 ( 3 % ) ,大部切除 4例 ( 7% ) .术后恢复良好 4 3例 ( 74 % ) ,好转 9例 ( 16% ) ,术后新增颅神经损伤 4例 ( 8% ) ,死亡 2例 ( 4 % ) .[讨论 ]根据肿瘤的大小和部位 ,选择恰当的手术入路 ,熟悉显微神经解剖关系 ,熟练应用手术技巧能够提高肿瘤的全切率。BACKGROUND?The operative approaches and microsurgical effects of meningioma were reviewed and it was studied how to rise the total removal rate, reduce operative mortality and improve operative effects.?CASE REPORT?58 cases of meningioma operated from November, 1997 to September, 2001 were retrospectively analyzed. The microsurgical treatment was performed for meningioma by using 6 kind of approaches, including the pteronal approach in 4 cases, the frontal approach in 2 cases, the approach of stride over agittal sinus in 24 cases, the suboccipital retromastoid approach in 5 cases, the suboccipital central approach in 2 cases and the approach depending on the locations of tumors in 21 cases. 61 of meningioma were excised removed in 58 cases. Total excision documented by postoperative CT scan was in 52 cases (90%), subtotal resections in 2(3%) and most of resections in 4(7%), and good postoperative effects were got in 43(74%), new cranial nerve deficits occurred in 4(8%) and operative death was in 2(4%).?DISCUSSION?It could improve total resections rates of meningioma and decrease the mortality rates that the measurable operative approach chosen according to the sizes and the locations of the tumor, acquaintance of the relation of neurotomy and skilled operative technique.

关 键 词：脑膜瘤 显微外科手术 治疗 病例报告 

分 类 号：R739.45[医药卫生—肿瘤]