内侧型蝶骨嵴脑膜瘤的显微外科治疗及影响肿瘤切除的因素分析  

Microsurgical treatment of medial sphenoid ridge meningioma and analysis of the factors affecting tumor resection

作　　者：陈露露[1] 苏贺先[1] 李健[1] 赵永轩[1] 徐德才[1] 刘后银[1] 张业森[1] CHEN Lu-lu(Department of Neurosurgery,first affiliated hospital of Bengbu Medical College,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233000

出　　处：《齐齐哈尔医学院学报》2019年第2期141-144,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨内侧型蝶骨嵴脑膜瘤的显微外科治疗经验及影响肿瘤切除的因素。方法回顾性分析了2013年1月—2018年3月在本院显微外科接受手术治疗的57例蝶骨内侧型蝶骨嵴脑膜瘤患者的临床资料。采用单因素分析肿瘤大小、侵犯海绵窦、粘连颈内动脉对切除程度的影响。结果患者平均年龄49.5岁。平均肿瘤直径为4.2 cm。肿瘤全切除40例(70.2%),次全切除13例(22.8%),部分切除4例(7.2%)。随访期间复发9例(15.8%),无死亡病例。单因素分析结果显示,肿瘤的切除程度是由多种因素决定的,包括肿瘤侵犯海绵窦、直接粘连颈内动脉及分支以及肿瘤大小。结论显微外科治疗仍然是内侧型蝶骨嵴脑膜瘤的主要治疗选择,肿瘤侵犯海绵窦、粘连颈内动脉及分支以及肿瘤大小是影响肿瘤全切除的主要因素,良好的开颅手术技术和最佳手术策略对于提高切除率和提高预后至关重要。Objective To explore the experience of microsurgical treatment of medial sphenoid ridge meningioma and the factors affecting tumor resection.Methods The clinical data of 57 patients with sphenoidal ridge meningioma treated by microsurgery from January 2013 to March 2018 were retrospectively analyzed.Univariate analysis method was used to analyze the influence of tumor size,invasion of cavernous sinus,adhesion of internal carotid artery on the extent of resection.Results The average age of this group of patients was 49.5 years old.The average tumor size was 4.2 cm.Total tumor resection was achieved in 40 patients(70.2%),subtotal resection in 13 patients(22.8%),and partial resection in 4 patients(7.2%).There were 9 cases(15.8%)recurring during the follow-up period,and there were no death.Univariate analysis showed that the degree of tumor resection was determined by a variety of factors,including tumor invasion of the cavernous sinus,direct adhesion of the internal carotid artery and branches and tumor size.Conclusions Microsurgical treatment is still the main treatment option for medial sphenoid ridge meningioma.Invasion of cavernous sinus,adhesion of internal carotid artery and branch,and tumor size are the main factors affecting total tumor resection.Good craniotomy technique and the best surgical strategies are essential for improving resection rates and improving prognosis.

关 键 词：内侧型蝶骨嵴脑膜瘤 显微手术 切除程度 

分 类 号：R739[医药卫生—肿瘤]