显微外科手术应用于颅底巨大脑膜瘤的效果及并发症分析  

Analysis of the effect and complications of microsurgery for giant skull base meningioma

作　　者：赵锐[1] 谭云[1] 张鹏[1] 刘明东[1] ZHAO Rui;TAN Yun;ZHANG Peng;LIU Mingdong(Department of Neurosurgery,Chongqing Three Gorges Central Hospital,Chongqing 404000,Chin)

机构地区：[1]重庆三峡中心医院神经外科,重庆404000

出　　处：《癌症进展》2018年第7期837-840,共4页Oncology Progress

摘　　要：目的探究显微外科手术应用于颅底巨大脑膜瘤的效果及并发症发生情况。方法选取进行显微外科手术切除颅底巨大脑膜瘤的79例患者作为研究对象。比较不同部位颅底巨大脑膜瘤患者的临床表现、影像学结果,以及术后治疗效果及并发症发生情况。结果颅底巨大脑膜瘤患者以头痛症状最为常见,占56.96%;其次为视力障碍,共有26例患者,占32.91%;精神症状较为少见,仅有4例患者伴有精神症状,占5.06%。对患者随访1年,发现术后最常见的并发症为术后神经功能障碍加重,发生率为32.91%;其次为脑脊液漏及颅内出血,分别发生6例及5例,分别占7.59%、6.33%。79例患者中19例为嗅沟脑膜瘤,占24.05%;15例为鞍区脑膜瘤,占18.99%;15例为蝶骨嵴脑膜瘤,占18.99%;6例为岩斜区脑膜瘤,占7.59%;24例为后颅窝脑膜瘤,占30.38%。显微外科手术治疗以嗅沟区颅底巨大脑膜瘤全切率最高,术后死亡率最低,复发率最低;而治疗效果以岩斜区颅底巨大脑膜瘤最差。结论显微外科手术应用于颅底巨大脑膜瘤的治疗,可获得较好的治疗效果及安全性,值得广泛应用于临床。Objective To analyze the effect and complications of microsurgery in the treatment of giant skull base meningioma. Method 79 patients who underwent microsurgical resection of giant skull base meningioma were included in the study. The clinical manifestation, imaging findings, postoperative treatment and complications were compared. Re Result For patients with large skull base meningioma, headache was the most common symptom, accounting for 56.96%of all adverse reactions, followed by visual impairment, which was observed in a total of 26 patients（32.91%）; mental disorders were relatively rare, with only 4 cases（5.06%） were observed. The patients were followed up for 1 year, and it was found that the most common complication after surgery was neurological dysfunction, the incidence was 32.91%; followed by cerebrospinal fluid leakage and intracranial hemorrhage, which occurred in 6 and 5 cases, respectively, each had a proportion of 7.59% and 6.33%. In 79 patients, 19 cases of olfactory groove meningioma, accounted for 24.05% of all cases; 15 cases had meningiomas in sellar region, accounting for 18.99%; 15 cases of sphenoid ridge meningiomas, accounting for 18.99%; 6 cases of petroclival meningiomas made up 7.59% of all cases; 24 cases were with posterior fossa meningioma, constituting 30.38% of all cases. The microsurgical treatment showed the highest total resection rate, the lowest mortality rate, and the bottom recurrence rate in olfactory groove meningioma among all types of giant skull base meningioma; while the worst outcome was observed in petroclival meningioma. Conclusion Microsurgery for giant meningiomas in the skull base is rather effective and safe, which is worthy of clinical application.

关 键 词：显微外科手术 颅底巨大脑膜瘤 治疗效果 并发症 

分 类 号：R739.41[医药卫生—肿瘤]