矢状窦旁脑膜瘤的显微手术治疗

Microsurgery for parasagittal meningiomas

目的探讨矢状窦旁脑膜瘤的手术方法与技巧。方法回顾分析36例矢状窦旁脑膜瘤的影像学资料、手术入路、显微手术方法。结果36例肿瘤全切除,其中28例Simpson Ⅰ级切除,6例SimpsonⅡ级切除,2例SimpsonⅢ级切除。术后随访6-24个月,恢复良好,无手术死亡病例。结论在显微手术操作下,矢状窦旁脑膜瘤的手术切除程度可达Simpson Ⅰ-Ⅱ级;良好的手术暴露、有效地控制和减少术中出血、妥善处理上矢状窦,保护好中央沟静脉、避免脑重要功能区的损伤是保证手术成功、达到良好预后的关键。

Objective To explore the operative of parasagittal meningiomas. Methods The clinical data of 36 patients with parasagittal meningiomas were analyzed retrospectively, which included imaging data, the operative approach, and microsurgery method. Results Simpson Ⅰ, Ⅱ ,Ⅲgrade resection was achieved in 28,6 and 2 of the 36 patients in this series respectively. The follow - up period ranged from 6 to 24 months. All the patients recovered well. There was no postoperative death. Conclusion Using microsurgical techniques, Simpson Ⅰ - Ⅱ grade resection can be reached for parasagittal meningiomas. Adequate surgical exposure, efficient management of operative bleeding,protecting and replacement of the sagittal sinus, andavoidence of damage to the brain tissues are the key factors to improve operative effect.