脑室内脑膜瘤的手术治疗(附30例分析)  

Surgical treatment of intraventricular meningiomas(report of 30 cases)

作　　者：邬迎喜[1] 赵天智[1] 赵兰夫[1] 吕文海[1] 王元[1] 薛亚飞[1] 贺世明[1] 

机构地区：[1]第四军医大学唐都医院神经外科,西安710000

出　　处：《中国临床神经外科杂志》2017年第10期690-692,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨脑室内脑膜瘤的手术方法及其效果。方法回顾性分析2005年1月到2015年10月收治的30例脑室内脑膜瘤的临床资料。侧脑室脑膜瘤26例中,19例采用顶枕入路,2例经颞中部入路,5例经胼胝体入路;4例第四脑室脑膜瘤采用枕骨下入路。结果 28例(93.3%)肿瘤全切除,2例(6.7%)次全切除。无手术死亡病例。术前头痛18例中,术后仅2例有头痛;术前神经功能缺损20例中,术后18例基本治愈;术前视力下降的3例术后均明显改善。术后发生脑积水4例、癫痫5例。术后随访9~226个月,平均65.2个月。术后6个月影像学随访表明5例(16.7%)复发,再次手术治疗;术后2年肿瘤无进展生存率为84.6%,随访期间保持在78.2以上。结论对于脑室内脑膜瘤,手术入路需根据肿瘤大小、位置和肿瘤偏向来选择。Objective To explore the outcomes and complications of surgical treatment of intraventricular meningiomas(IVM).Methods The clinical data of 30 patients with IVM undergoing surgery from January, 2005 to october, 2015 were analyzed retrospectively. Results Of 30 patients with IVM, 28 received the total resection of the tumors and 2 subtotal resection. No patients died of surgery. The progressing-free survival rate was 83.3%(25/30) two years after the surgery. After the surgery, headache disappeared in16 of 18 patients with preoperative headache, neurologic deficits were cured in 18 of 20 patients with preoperative neurologic deficits and visual power was improved significantly in 3 patients with preoperative visual impairment. There was no recurrence of tumors in 25 patients and the tumors recurred in 5 patients 2 years after the surgery. Conclusion The surgical approach should be selected according to the tumorous size, location, and laterality in the patients with IVM.

关 键 词：脑室内脑膜瘤 显微手术 手术入路 疗效 

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