蝶骨嵴内侧脑膜瘤围手术期的处理要点  

Perioperative treatment of the medial sphenoid ridge meningioma

作　　者：李仲森 傅先明[1] 费小瑞[1] 钱若兵[1] 何金超 贾力[1] 牛朝诗[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科,合肥230001

出　　处：《中国微侵袭神经外科杂志》2015年第6期256-258,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨蝶骨嵴内侧型脑膜瘤围手术期处理策略。方法回顾性分析46例蝶骨嵴内侧型脑膜瘤的病例资料,均采用显微神经外科治疗。经翼点或扩大翼点入路45例,经额底入路1例。结果根据脑膜瘤Simpson切除分级:Ⅰ级4例,Ⅱ级16例,Ⅲ级17例,Ⅳ级9例。术后出现意识改变、肢体轻瘫4例,神经精神症状3例,瘤腔渗血1例。愈后良好24例,一般18例,差3例,死亡1例。结论显微外科切除是蝶骨嵴脑膜瘤治疗最有效的方法,详细全面的术前评估、个体化的手术治疗策略、扎实的颅底解剖知识,熟练的手术技巧,术后并发症及时处理等围手术期处理策略,是提高蝶骨嵴内侧脑膜瘤治疗效果和愈后的关键因素。Objective To investigate the perioperative management strategies for medial sphenoid ridge meningioma （MSRM）. Methods The clinical data of 46 MSRM patients undergoing neuro-microsurgery were analyzed retrospectively. The pterional or extended pterional approach was adopted in 45 patients and subfrontal approach in 1. Results According to Simpson resection grade for meningioma, grade Ⅰ was in 4 cases, grade Ⅱ in 16, grade Ⅲ in 17 and grade Ⅳ in 9. The consciousness alteration and hemiplegia appeared in 4 patients, neuropsychiatric symptoms in 3 and tumor cavity bleeding in 1. The recover was good in 24 patients, fair in 18, and poor in 3, and one patient died. Conclusions The surgical resection is the most effective treatment for sphenoid ridge meningiomas. The detailed and comprehensive preoperative evaluation, individualized surgical treatment strategy, solid anatomical knowledge on the skull base and skilled surgical techniques and timely treatment of postoperative complications are key factors for improving therapeutic efficacy and prognosis of MSRM.

关 键 词：脑膜瘤 蝶骨嵴 显微外科治疗 围手术期 

分 类 号：R739.45[医药卫生—肿瘤] R651.11[医药卫生—临床医学]