小脑幕脑膜瘤显微手术治疗

Microsurgical treatment of tentorial meningiomas

目的:探讨小脑幕脑膜瘤显微手术治疗的技巧,以降低死亡率。方法:回顾分析显微手术治疗小脑幕脑膜瘤32例的临床资料,总结小脑幕脑膜瘤的显微手术方法、手术结果和术后处理。结果在32例中,手术全切除肿瘤27例(84.37%),次全切除5例(15.63%)。在未全切除的5例中,3例肿瘤与侵蚀颅内静脉窦,2例肿瘤与脑干、血管及颅神经紧密粘连或受肿瘤侵犯有关。结论:选择好手术入路和运用好显微外科技术可以提高小脑幕脑膜瘤的全切率,降低死亡率。

Objective To discuss microsurgery in the treatment of tentorial meningiomas to reduce the operative mortality. Methods Clinical data of 32 patients were retrospectively analyzed. The operative approaches and outcomes and postoperative management of tentorial meningiomas were discussed. Results Of the 32 patients, tumors in 27 patients （ 84. 37% ） were removed totally, and 5 （ 15.63 % ） were removed subtotally. In the 5 patients whose tumors were resected subtotally, 3 patients were related to major sinus, and the other 2 related to adhering compactly to the brain stem invaded by tumors, major vessels, or cranial nerves. Conclusion Total resection can be achieved in most patients with microneurosurgical technique. Proper choice of operative approaches may raise the total removal rate and lower the operative mortality.