内侧型蝶骨嵴脑膜瘤的手术治疗及术后复发的相关因素分析  

Microsurgical treatment and factors related to postoperative recurrence of medial sphenoid wing meningiomas

作　　者：王龙[1] 焦建同[1] 欧阳陶辉[1] 李政[1] 章剑剑[1] 曾令成[1] 叶飞[1] 陈坚[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉430030

出　　处：《中国临床神经外科杂志》2014年第12期705-708,共4页Chinese Journal of Clinical Neurosurgery

基　　金：国家临床重点专科建设项目资助

摘　　要：目的探讨内侧型蝶骨嵴脑膜瘤显微手术治疗方法及术后复发的相关因素。方法回顾性分析2008年至2014年显微手术治疗的61例内侧型蝶骨嵴脑膜瘤患者的临床资料,并应用Kaplan-Meier法、log-rank检验及Cox比例风险回归模型分析影响肿瘤术后复发的相关危险因素。结果肿瘤全部切除36例,部分切除25例。术后死亡2例。46例术后随访1~75个月,肿瘤复发18例,复发率39.1%。统计学分析显示肿瘤侵犯海绵窦或颅骨、包绕颈内动脉及其分支、恶性病理学特征及部分切除是肿瘤复发的独立危险因素。结论术中对肿瘤遵循去血管化、严格蛛网膜平面操作、尽可能实行原位切除等显微手术原则,可提高肿瘤的全切除率、最大程度减少术后复发率并获得满意的手术疗效。Objective To summarize the microsurgical technique of medial sphenoid wing meningiomas （mSWMs） and analyze the factors influencing their recurrence. Methods The clinical data of 61 patients with mSWMs treated by microsurgery in our hospital from January, 2008 to August, 2014 were analyzed retrospectively. The factors related to recurrence of mSWMs were analyzed by Kaplan-Meier method, log-rank test and Cox multivariate regression analysis. Results Of 61 patients with mSWMs, 36 received total resection of mSWMs and 25 part. Two patients died after the operation. The tumors recurred in 18 patients （39.1%） from 8 to 48 months after the operation. The statistical analyses showed that the independent risk factors of mSWMs recurrence included tumor invading the cavernous sinus or skull bone, or wrapping the intracranial carotid artery or its branches, atypical histopathological features and tumorous residue. Conclusions The good curative effects of microsurgery on mSWMs may be obtained by the tumorous devascularition, all the dissections within the araehnoidal planes and orthotopic resection of the tumors as far as possible, including the high rate of total resection of the tumors, low rate of the recurrence of the tumors and so on.

关 键 词：内侧型蝶骨嵴脑膜瘤 显微手术 肿瘤复发 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]