蝶骨嵴脑膜瘤的手术治疗

Microsurgical Treatment of Sphenoid Ridge Meningiomas

目的:探讨蝶骨嵴脑膜瘤的诊断、分型、手术入路、切除方式并总结手术治疗效果。方法:回顾性分析27例蝶骨嵴脑膜瘤患者的临床表现、影像学资料、手术入路、切除程度和其中25例患者的随访资料。结果:肿瘤全切(Simpson Ⅰ级和Ⅱ级)18例(66.67%),次全切9例(33.33%),死亡1例。术后患者颅内高压、视力下降及眼球突出等临床症状均有不同程度地改善和恢复。随访25例6个月-7年,复发3例,1例行二次手术。结论:术前应根据肿瘤的位置及周围结构受累的情况选择合适的手术入路及切除方式,熟练掌握术区解剖及显微手术操作,可以提高肿瘤全切率,减少术后并发症,降低致残率和复发率。

Objective： Sphenoid ridge meningiomas （SRM） was treated microsurgically and the effectiveness was evaluated. Methods ： Twenty-seven patients with SRM who were treated microsurgically in our hospital were retrospectively reviewed. Results：Total removal （Simpson groups Ⅰ and Ⅱ） was done in 18 （66.67%） patients and subtotal removal in 9 （33.33 %）. The symptoms such as increased intracranial pressure were improved to some degree after operation. Twenty-five cases were followed up from 6 months to 7 years. Tumor recurred in 3 cases, and a second surgery was performed on 1 case. One patient died. Conclusion： Appropriate surgical approach and resection way should be decided according to the sites of tumors attached to the dura and the surrounding structures. Full understanding of microanatomy and experienced operating skill are the prerequisite of improving the successful tumor-removal and of decreasing complications.