大脑镰旁脑膜瘤显微手术治疗效果及预后影响因素分析  

Evaluation of the effect and prognosis of 65 cases of microsurgery for meningiomas near the falx

作　　者：杨旭 李宗平 陈旭 YANG Xu;LI Zongping;CHEN Xu(Department of Neurosurgery,Mianyang Central Hospitl,School of Mediccine,University of Electronic Science and Technology of China,Mianyang,Sichuan 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院神经外科,四川绵阳621000

出　　处：《医药前沿》2021年第16期11-12,15,共3页Journal of Frontiers of Medicine

摘　　要：目的:分析显微手术治疗大脑镰旁脑膜瘤的效果及预后情况。方法:选取我院神经外科2018年1月—2020年8月收诊的大脑镰旁脑膜瘤患者65例,均给予显微手术治疗,观察治疗效果,并根据预后是否复发分成预后良好组、预后不良组,并分析预后的影响因素。结果:65例患者肿瘤切除程度(Simpson分级):Ⅰ级占47.69%,Ⅱ级占47.69%,Ⅲ级占4.62%;65例患者均手术成功,术中出血量平均(320.5±46.3)mL,术后并发症发生率为7.69%,均经对症治疗后缓解;预后良好组患者Ki-67指数阳性率、肿瘤直径均低于预后不良组;且预后良好组的肿瘤切除分级为Ⅰ级概率高于预后不良组,差异均具有统计学意义(P<0.05)。结论:大脑镰旁脑膜瘤患者应用显微手术治疗疗效肯定,但肿瘤大小、肿瘤切除程度以及术后Ki-67指数都会对预后产生一定影响,临床医师应结合患者的个体化情况选择最佳手术方案,尽可能提高肿瘤切除程度,并在术后加强对Ki-67指数的随访监测,及早发现复发的征兆,及早对症治疗。Objective To explore the effect of microsurgery in the treatment of parasickle meningioma,and to investigate and analyze the prognostic factors.Methods From January 2018 to August 2020 in our hospital neurosurgery,65 patients with parasickle meningioma were selected as subjects,and they were treated with microsurgery.The surgical treatment effects of 65 patients were collected and sorted out.According to whether the prognosis recurred,they were divided into a good prognosis group and a poor prognosis group.The clinical data of the two groups were collected and analyzed,and the factors affecting the prognosis were analyzed.Results The degree of tumor resection in 65 patients was graded by Simpson:Grade I accounted for 47.69%,Grade II accounted for 47.69%,Grade III accounted for 4.62%;65 patients were successful in operation,and the average bleeding volume was(320.5±46.3)mL;The incidence of postoperative complications was 7.69%,which was relieved after symptomatic treatment;The positive rate of Ki-67 index and tumor diameter in patients with good prognosis were lower than those in patients with poor prognosis;And tumor diameter were lower than those in the poor prognosis group;And the tumor resection grade of the good prognosis group The probability of grade I was higher than that of the poor prognosis group,The differences were statistically significant(P<0.05).Conclusion Patients with parasickle meningiomas have a positive effect on microsurgery,but the size of the tumor,the degree of tumor resection,and the Ki-67 index after surgery will all have a certain impact on the prognosis.Clinicians should choose according to the individual situation of the patient The best surgical plan is to increase the degree of tumor resection as much as possible,and to strengthen the follow-up monitoring of the Ki-67 index after the operation,to detect the signs of recurrence as soon as possible,and to treat the symptoms early.

关 键 词：大脑镰旁脑膜瘤 显微手术 预后 复发 影响因素 

分 类 号：R739.45[医药卫生—肿瘤]