凸面脑膜瘤手术治疗120例分析

Analysis of 120 surgical cases with convexity meningioma

目的探讨凸面脑膜瘤的手术技巧、并发症和复发因素。方法回顾性分析经手术治疗的120例凸面脑膜瘤患者的临床资料。采用SPSS17．0统计分析软件，运用Kaplan-Meier法行生存分析。结果术后病理报告有105例（87．5％）良性脑膜瘤，12例（10．0％）非典型脑膜瘤和3例（2．5％）间变性脑膜瘤。有8例患者病理为良性脑膜瘤但肿瘤边缘有非典型细胞。2例良性肿瘤复发者均为病理切片中发现肿瘤边缘有非典型细胞。全组30d病死率为0。结论对凸面脑膜瘤患者应积极手术治疗，无论肿瘤的良恶性均应尽量做到SimpsonI级切除，术后根据肿瘤的病理类型考虑是否进一步行辅助治疗。虽然脑膜瘤复发的因素较多，但手术切除范围和肿瘤本身的组织病理学类型仍是复发的重要因素。

Objective To analyze the patients with convexity meningioma with respect to pathological factors leading to recurrence, surgical technique, and complication. Methads The data of 120 surgical cases of convexity meningioma were retrospectively reviewed. Statistical analysis were performed by SPSS 17.0 with method of Kaplan-Meier survival analysis. Results The 30-day mortality was 0. The pathology of the tumors was benign in 105 cases （87.5%）, atypical meningioma in 12 cases （10.0%）, and anaplastic/ malignant meningioma in 3 cases （2.5%）. In 8 eases designated benign, there were borderline atypical features. Two cases of benign tumor recurred whose pathology involved tumors with borderline atypia. Conclusions Patients with convexity meningioma should be actively operated, and Simpson I resection must be performed to the best of ability whether the tumors are benign or malignant. Further postoperative adjuvant treatment will be implemented or not according to the histopathological types of the tumors. Although there are many factors of recurrence for convexity meningioma. The range of surgical resection and pathological types are still the important causes for recrudescence.