中央回区矢状窦旁脑膜瘤的显微手术治疗  

Microsurgical treatment of parasagittal meningiomas in central area

作　　者：徐子明[1] 余新光[2] 朱儒远[2] 

机构地区：[1]广东省东莞市人民医院神经外科,523018 [2]解放军总医院神经外科

出　　处：《中华显微外科杂志》2003年第1期28-30,共3页Chinese Journal of Microsurgery

摘　　要：目的　提高中央回区矢状窦旁脑膜瘤的手术效果。　方法　应用显微手术治疗中央回区矢状窦旁脑膜瘤 2 0例 ,术前行DSA检查 16例 ,了解肿瘤的血供、矢状窦通畅程度及瘤周静脉回流代偿情况 ,采取先阻断窦旁供血 ,然后囊内或分块切除肿瘤 ,注意保护中央沟静脉、其他代偿回流静脉及瘤周正常脑组织 ,妥善处理受累的矢状窦。　结果　肿瘤全切除 17例 ,近全切除 3例 ,无手术死亡 ,术后遗有左侧轻偏瘫 1例 ,双下肢轻瘫 2例。 13例术后随访 3～ 7年 ,无肿瘤复发。　结论　采用显微手术切除中央回区矢状窦旁脑膜瘤可提高肿瘤全切除率 ,减少脑重要功能区的损伤 ,减少并发症 ,提高患者术后生存质量。Objective To improve the operative outcome of parasagittal meningiomas in central area. Methods Twenty patients with parasagittal meningiomas were treated with microsurgery. Of them, 16 cases were taken DSA exzamination before operation to evaluate the blood supplies of the tumor, compensation of venus return around the tumor after obstruction of the sagittal sinus. During the operation, the parasagittal blood supplies were blocked first, the tumors were resected piece by piece. Rolandic veins, other compensative venous pathways and normal brains around the tumors were protected, and the involved sagittal sinuses were appropriately treated. Results Total removal of the tumor was reached in 17 cases, nearly total removal in 3 cases, no death. Postoperatively, 1 patient developed hemiparesis, 2 had paresis of both lower extremities. No tumor recurrence was found in 13 patients during the follow-up of 3～7 years. Conclusion Using microsurgical techniques in the resection of parasagittal meningioma in central area may improve the percentage of total tumor resection, decrease the injuries of important functional area of the brain, reduce complications and improve survival outcome.

关 键 词：中央回区矢状窦旁脑膜瘤 显微手术 治疗 术前 

分 类 号：R739.45[医药卫生—肿瘤]