显微手术治疗矢状窦旁及大脑镰旁脑膜瘤患者疗效分析  

Microsurgical Treatment of Parasagittal and Parafalx Meningiomas

作　　者：苏裕茗 邓承能 谢坚[1] SU Yu-ming;DENG Cheng-neng;XIE Jian(Department of Neurosurgery,Yulin Red Cross Hospital,Yulin,Guangxi,537000 China)

机构地区：[1]玉林市红十字会医院神经外科

出　　处：《系统医学》2019年第9期114-116,共3页Systems Medicine

摘　　要：目的分析矢状窦旁及大脑镰旁脑膜瘤患者应用显微手术治疗的临床疗效。方法于2015-2018年在该院接受矢状窦旁及大脑镰旁脑膜瘤治疗的患者中进行随机抽取,该研究共计纳入研究对象50例,所有患者均接受显微手术治疗,分析病理分型及肿瘤切除程度以及临床疗效、并发症发生情况、肿瘤复发情况。结果病理分型结果为:3例不典型性患者、3例混合型患者、6例血管型患者、9例砂粒型患者、16例纤维型患者、13例内皮细胞型患者。依照Simpson脑膜瘤切除标准分级结果为:14例Ⅰ级患者、29例Ⅱ级患者、7例Ⅲ级患者。患者存活率为100%,17例一侧肢体无力患者中1例患者病情未见明显好转,2例患者术后病情加重,出现严重偏瘫,14例患者肌力较治疗前明显改善。术后4例术前肌力正常患者对侧肢体肌力出现减退反应,治疗后3周肌力明显恢复。术后4例患者肿瘤复发。5例颅骨瓣经高温灭活后还纳固定患者治疗后没有出现颅骨吸收表现。结论矢状窦旁及大脑镰旁脑膜瘤患者应用显微手术治疗能够取得确切的治疗效果,并发症发生率、病情复发率低,在辅助应用影像学检查并保证手术操作方式以及手术入路的合理性,能够使出血量得到有效控制,最大限度地避免功能区脑皮质、引流静脉以及矢状窦受损,能够有效提高手术治疗效果以及安全系数。Objective To analyze the clinical effect of microsurgery in the treatment of parasagittal and parafalx meningiomas. Methods A total of 50 patients with parasagittal and parafalx meningiomas from 2015 to 2018 were randomly selected in our hospital. All patients were treated by microsurgery. Pathological classification, degree of resection, clinical efficacy, complications and recurrence of the tumors were analyzed. Results Pathological classification results were as follows: 3 atypical patients, 3 mixed patients, 6 vascular patients, 9 sand patients, 16 fibrous patients and13 endothelial cell patients. According to the standard classification of Simpson meningioma excision, the results were as follows: 14 grade Ⅰ patients, 29 grade Ⅱ patients and 7 grade Ⅲ patients. The survival rate of the patients was100%. Of the 17 patients with unilateral limb weakness, 1 had no significant improvement, 2 had severe hemiplegia after operation, and 14 had better muscle strength than before. 3 weeks after treatment, 4 patients with normal muscle strength whose muscle strength of the contralateral limbs decreased experienced a significant recovery of muscle strength. Tumor recurrence occurred in 4 patients after operation. There were no signs of skull resorption in 5 cases of skull flaps after high temperature inactivation and fixation. Conclusion Microsurgical treatment of parasagittal and parafalx meningiomas can achieve definite therapeutic effect. The incidence of complications and recurrence rate of the disease are low. In addition, auxiliary application of imaging examination help ensure the rationality of the operation mode and the surgical approach. The amount of bleeding can be effectively controlled, and the cortex, drainage vein and sagittal sinus injury can be avoided to the greatest extent. It can effectively improve the surgical treatment effect and safety factor.

关 键 词：显微手术 矢状窦旁脑膜瘤 大脑镰旁脑膜瘤 临床疗效 

分 类 号：R729.45[医药卫生—儿科]