显微外科手术治疗功能区矢状窦镰旁脑膜瘤的疗效观察

Observation of curative effect of microsurgery on parasagittal and parafalcine meningioma in functional area

目的了解显微外科手术治疗功能区矢状窦大脑镰旁脑膜瘤的效果。方法我院自1980年4月至2007年4月收治81例矢状窦镰旁脑膜瘤患者,2000年1月前收治的40例采用常规手术治疗(设为常规手术组),2000年1月后收治的41例采用显微外科手术治疗(设为显微手术组),比较两组的疗效。结果常规手术组术中输血量(1200.2+423.5)mL,肿瘤全切除率为60.0%,症状改善率80.0%,致残率12.5%,术后病死率7.5%。显微手术组术中输血量(400.7+220.2)mL,肿瘤全手术切除率87.8%,症状改善率97.5%,致残率0%,术后病死率2.4%。两组的术中输血量、肿瘤全切除率、疗效差异有统计学意义(P<0.01或0.05)。结论显微外科手术能明显减少术中出血,提高肿瘤全切除率,改善症状。

Objective To observe the curative effect of microsurgery on parasagittal and parafalcine meningioma in the functional area. Methods Information from 81 patients with parasagittal and parafalcine meningiomas in the eloquent brain areas were collected in Central Hospital of Guangdong Province Agricultural Reclamation from April 1980 to April 2007. Forty cases underwent routine surgical treatment （conventional surgical group） before january 2000. Forty one cases received the microsurgery （microsurgical group） after January 2000. Results In the conventional surgical group, mean bloDd transfusion volume was （ 1200.2 ± 423.5） mL, complete resection rate was 60.0 %, symptom improvement rate was 80.0 %, disability rate was 12.5 %,and mortality rate was 7.5%. In the microsurgical group, mean blood transfusion volume was （400.7 ± 220.2） mL, complete resection rate was 87.8%, symptom improvement rate was 97.5%, disability rate was 0 and mortality rate was 2.4%. Compared with the conventional surgical group, the microsurgical group needed significantly lower blood transfusion volume, had significantly higher complete resection rate and symptom improvement rate, and lower disability rate and mortality rate. Conclusion Micrcsurgery enhances the completeness of meningioma resection, reduces the mortality and improves patients＇ symptom apparently.