25例嗅沟巨大脑膜瘤的手术体会  

Surgical experience of giant olfactory groove meningioma in 25 cases

作　　者：鲍永峰[1] BAO Yong-feng(Department of Neurosurgery,Zaozhuang Municipal Hospital,Zaozhuang 277101,China)

机构地区：[1]枣庄市立医院神经外科,277101

出　　处：《中国实用医药》2020年第35期29-31,共3页China Practical Medicine

摘　　要：目的总结嗅沟巨大脑膜瘤的手术治疗效果,为进一步提升嗅沟巨大脑膜瘤的治疗水平提供帮助。方法回顾性分析在援外过程中手术治疗的25例嗅沟巨大脑膜瘤患者的一般资料、手术策略, 25例患者均采取双额冠状切口,额下或联合前纵裂入路进行脑膜瘤显微手术,对手术疗效进行归纳总结。结果 25例患者中SimpsonⅡ级切除15例, SimpsonⅢ级切除8例, SimpsonⅣ级切除2例。平均住院天数(10±3)d。24例恢复良好,术后视力较术前改善13例、占72%(13/18), 2例轻度言语障碍的患者出院时明显好转,所有术前嗅觉丧失的患者术后嗅觉无改善, 1例死亡。25例肿瘤术后病理结果为:内皮型7例,成纤维型5例,砂粒型2例,血管型5例,混合型4例,恶性脑膜瘤2例。结论针对嗅沟巨大脑膜瘤尤其是恶性或侵及鞍区等重要结构者,在尽可能切除肿瘤的同时,手术应最大限度保护脑组织及重要解剖结构,以生命安全为前提。Objective To summarize the surgical treatment effect of giant olfactory groove meningioma,and provide help for further improving the treatment level of giant olfactory groove meningioma.Methods The general information and surgical strategy of 25 patients with giant olfactory groove meningioma treated by surgery in the process of foreign aid were retrospectively analyzed.All 25 patients underwent double frontal coronal incision,subfrontal or combined anterior longitudinal fissure approach for meningioma microsurgery,and summarized the surgical results.Results Among the 25 patients,15 cases were Simpson gradeⅡresection,8 cases were Simpson gradeⅢresection,and 2 cases were Simpson gradeⅣresection.The average hospitalization time was(10±3)d.24 cases recovered well,13 cases had improved visual acuity compared with preoperative,accounting for 72%(13/18);2 cases of mild speech impairment improved significantly at discharge,all patients with preoperative olfactory loss had no improvement after operation,and 1 case died.The postoperative pathological results of 25 patients:7 cases of endothelial type,5 cases of fibroblast type,2 cases of grit type,5 cases of vascular type,4 cases of mixed type,and 2 cases of malignant meningioma.Conclusion For patients with giant olfactory groove meningioma,especially those with malignant tumors or invading sellar region and other important structures,the operation should protect the brain tissues and important anatomical structures to the maximum extent while removing the tumors as far as possible.

关 键 词：嗅沟脑膜瘤 手术 治疗效果 

分 类 号：R739.45[医药卫生—肿瘤]