显微镜下微创切除手术与传统开颅手术对矢状窦旁及大脑镰旁脑膜瘤的疗效及安全性分析  

Analysis of Efficacy and Safety of Microscopic Minimally Invasive Surgery and Traditional Craniotomy Surgery for Parasagittal Sinus and Parafalx Cerebri Meningiomas

作　　者：黄斌[1] 谭智灵[1] 王荣彦 白桂斌 廖佐明 岳晓 罗忠平[1] 邓人富[1] HUANG Bin;TAN Zhiling;WANG Rongyan(Affiliated Hospital of Xiangnan University, Hunan Chenzhou 423099, China)

机构地区：[1]湘南学院附属医院神经外科,湖南郴州423000

出　　处：《河北医学》2020年第4期681-686,共6页Hebei Medicine

基　　金：湖南省医药卫生科研计划课题,(编号:B2015-064)。

摘　　要：目的:对比显微镜下微创切除手术与传统开颅手术对矢状窦旁及大脑镰旁脑膜瘤的疗效及安全性。方法:选择2015年1月至2018年1月我院接诊的86例矢状窦旁及大脑镰旁脑膜瘤患者纳入研究,通过简单随机数表法分为观察组46例和对照组40例,观察组使用显微镜下微创切除手术治疗,对照组使用传统开颅手术治疗。比较两组围术期情况、肿瘤切除Simpson分级、症状缓解情况及复发率。结果:观察组手术时间明显长于对照组,术中出血量、术中输血量明显少于对照组,住院时间明显比对照组短(P<0.05);两组肿瘤切除Simpson分级比较差异有统计学意义(P<0.05);手术后,观察组肢体功能障碍、感觉障碍、癫痫症状较手术前均明显改善,对照组肢体功能障碍明显改善(P<0.05),观察组肢体功能障碍明显低于对照组(P<0.05);随访结果显示,观察组总复发率明显低于对照组(P<0.05)。结论:和传统开颅手术相比,显微镜下微创切除手术对矢状窦旁及大脑镰旁脑膜瘤患者的切除效果更好,并具有创伤小、促进临床症状恢复、复发率低等优点,值得应用推广。Objective:To compare the efficacy and safety of microsurgery with traditional craniotomy in the treatment of parasagittal sinus meningiomas and parafalx meningiomas.Methods:From January 2015 to January 2018,86 patients with parasagittal sinus meningiomas and parafalx meningiomas in our hospital were selected for the study.They were divided into observation group(46 cases)and control group(40 cases)by simple random number table method.Observation group was treated with microsurgery and control group with traditional craniotomy.The perioperative condition,Simpson grade of tumor resection,symptom relief and recurrence rate were compared between the two groups.Results:The operation time in the observation group was significantly longer than those in the control group,the amount of bleeding and blood transfusion during operation were significantly less than those in the control group,and the hospitalization time was significantly shorter than those in the control group(P<0.05).The Simpson grading of tumor resection between the two groups has statistically significant(P<0.05).After operation,the symptoms of limb dysfunction,sensory disturbance and epilepsy in the observation group were significantly improved compared with those before operation,while the limb dysfunction in the control group were significantly improved(P<0.05).The limb dysfunction in the observation group was significantly lower than those in the control group(P<0.05).In the follow-up results showed that the total recurrence rate in the observation group was significantly lower than those in the control group(P<0.05).Conclusion:Compared with traditional craniotomy surgery,the microsurgical minimally invasive surgery is more effective for parasagittal sinus and parafalx cerebri meningiomas,it has the advantages of less trauma,promoting the recovery of clinical symptoms and low recurrence rate.,which is worthy of application and promotion.

关 键 词：脑膜瘤 矢状窦旁 大脑镰旁 显微镜下微创切除手术 传统开颅手术 

分 类 号：R739.45[医药卫生—肿瘤]