经小脑幕入路与经岩骨乙状窦前入路治疗岩斜区脑膜瘤的效果观察  

Effect of Transtentorial Approaches and Transpetrosal Presigmoid Approaches in the Treatment of Petroclival Meningiomas

作　　者：王东流[1] 管义祥[1] WANG Dongliu;GUAN Yixiang(Haian People's Hospital Affiliated to Nantong University,Haian,226600)

机构地区：[1]南通大学附属海安市人民医院,226600

出　　处：《实用癌症杂志》2020年第3期514-516,共3页The Practical Journal of Cancer

摘　　要：目的比较经小脑幕入路与经岩骨乙状窦前入路治疗岩斜区脑膜瘤的效果。方法60例岩斜区脑膜瘤患者均采取脑膜瘤切除术治疗,按照手术入路方式不同分为2组。对照组经小脑幕入路,观察组经岩骨乙状窦前入路。比较2组术后并发症、手术切除程度,手术前后的NIHSS评分值,术后3年的复发情况。结果观察组的手术根治性切除率明显高于对照组(P<0.05),但观察组的术后并发症发生率明显高于对照组(P<0.05)。2组术后1、4、8个月的NIHSS评分值均明显低于术前(P<0.05),且观察组明显低于对照组(P<0.05)。观察组的肿瘤复发率为3.13%(1/32),明显低于对照组的14.29%(4/28)(P<0.05)。结论经岩骨乙状窦前入路对岩斜区脑膜瘤的切除率明显高于经小脑幕入路,且术后神经功能损伤恢复更为显著、复发率较低,但有较高的术后并发症发生风险。Objective To study the effect of transtentorial approaches and transpetrosal presigmoid approaches in the treatment of petroclival meningiomas.Methods Selected 60 patients with petroclival meningiomas.The patients were divided into 2 groups according to the difference of surgical approaches.The control group underwent tentorium cerebellum approach and the observation group underwent presigmoid petrosal approach.Compare the complications,degree of resection,NIHSS score before and after operation,and the recurrence in 3 years after operation between the 2 groups.Results The rate of radical resection in the observation group was significantly higher than the control group(P<0.05).The incidence of complications in the observation group was significantly higher than the control group(P<0.05).The NIHSS scores of the 2 groups at 1,4 and 8 months after operation were significantly lower than before operation(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The recurrence rate of tumors in the observation group was 3.13%(1/32),which was significantly lower than the control group 14.29%(4/28)(P<0.05).Conclusion The resection rate of petroclival meningiomas via presigmoid petrosal approach is significantly higher than that via tentorium cerebellum approach,and the recovery of postoperative neurological damage is more significant and the recurrence rate is lower,but there is a higher risk of postoperative complications.

关 键 词：经小脑幕入路 经岩骨乙状窦前入路 岩斜区脑膜瘤 

分 类 号：R739.45[医药卫生—肿瘤]