显微外科手术治疗中央区窦镰旁大型脑膜瘤的效果探究  

The effect of microsurgery in the treatment of large paranasal meningioma in central region

作　　者：赵振新 和崇军 和桥顺 张四红 寸传孝 王俊逸 ZHAO Zhenxin;HE Chongjun;HE Qiaoshun;ZHANG Sihong;CUN Chuanxiao;WANG Juny i(Lijiang People’s Hospital,Lijiang 674100,Yunnan,China)

机构地区：[1]丽江市人民医院,云南丽江674100

出　　处：《当代医药论丛》2022年第2期52-55,共4页

基　　金：丽江市科技计划项目,项目编号:2020LJSFK016。

摘　　要：目的:研究用显微外科手术治疗中央区窦镰旁大型脑膜瘤的效果。方法:将44例中央区窦镰旁大型脑膜瘤患者作为研究对象。对这些患者均进行显微外科手术,然后观察其各项临床指标。结果:术后,采用Simpson分级法对44例患者脑膜瘤切除的程度进行分级的结果显示,脑膜瘤在中央区侵犯大脑镰及矢状窦壁的23例患者中,脑膜瘤SimpsonⅠ级切除、SimpsonⅡ级切除的患者分别有17例、6例;脑膜瘤在中央区侵犯大脑镰及矢状窦腔的7例患者中,脑膜瘤SimpsonⅠ级切除、SimpsonⅣ级切除的患者分别有4例、3例;脑膜瘤在中央区皮层深部只侵犯大脑镰的6例患者均实现脑膜瘤SimpsonⅠ级切除;脑膜瘤在中央区皮层凸面只侵犯矢状窦的8例患者中,脑膜瘤SimpsonⅠ级切除、SimpsonⅡ级切除、SimpsonⅣ级切除的患者分别有3例、3例、2例。术后进行随访得知,脑膜瘤SimpsonⅠ级切除的30例患者术后病情的复发率为0.00%,脑膜瘤SimpsonⅡ级切除的9例患者术后病情的复发率为11.11%,脑膜瘤SimpsonⅣ级切除的5例患者术后病情的复发率为20.00%。术后,发生偏瘫的患者有11例,其中术后1年内偏瘫完全恢复的患者有7例,余下4例患者偏瘫部分恢复,无患者死亡。44例患者的平均治疗费用为(4.16±0.51)万元。结论:用显微外科手术治疗中央区窦镰旁大型脑膜瘤的效果显著,具有手术的成功率高、术后患者病情的复发率和死亡率低等优点。Objective:To study the effect of microsurgery in the treatment of large paranasal meningioma in central region.Methods:44 patients with large paranasal meningioma in central area were studied.Microsurgery was performed on all patients and clinical indicators were observed.Results:After surgery,Simpson grading method was used to grade the degree of meningioma resection in 44 patients.The results showed that among 23 patients with meningioma invading the central region of falx cerebrum and sagittal sinus wall,there were 17 and 6 patients with Simpson GRADEⅰand Simpson gradeⅱmeningioma resection,respectively.Among the 7 patients with meningioma involving falx cerebrum and sagittal sinus lumen in the central region,Simpsonⅰand Simpsonⅳresection were performed in 4 and 3 cases,respectively.Simpsonⅰmeningioma resection was performed in 6 patients with meningioma deep in the central cortex only involving falx cerebellum.Among the 8 patients with meningioma only invading the sagittal sinus on the convex surface of the central cortex,Simpsonⅰ,Simpsonⅱand Simpsonⅳresection were performed in 3,3 and 2 cases,respectively.Postoperative follow-up showed that the recurrence rate of 30 patients with Simpson GRADEⅰmeningioma resection was 0.00%,that of 9 patients with Simpson Gradeⅱmeningioma resection was 11.11%,and that of 5 patients with Simpson Gradeⅳmeningioma resection was 20.00%.After surgery,there were 11 patients with hemiplegia,among which 7 patients had complete recovery of hemiplegia within 1 year after surgery,and the remaining 4 patients had partial recovery of hemiplegia,and no patient died.The average treatment cost of 44 patients was(4.16±0.51)YUAN.Conclusion:Microsurgery in the treatment of large meningioma beside the falx in the central region is effective,with high success rate of operation,low recurrence rate and mortality ra te.

关 键 词：显微外科手术 中央区窦镰旁大型脑膜瘤 Simpson分级 

分 类 号：R615[医药卫生—外科学]