血供丰富内侧型蝶骨嵴脑膜瘤显微手术治疗(附28例临床分析)

Microsurgical treatment of medial sphenoid ridge meningioma rich in blood supply

目的探讨血供丰富内侧型蝶骨嵴脑膜瘤的术前评估及治疗方法。方法回顾性分析经显微手术治疗的28例血供丰富内侧型蝶骨嵴脑膜瘤,CTA或DSA明确瘤周血管走形及肿瘤血供情况,发现肿瘤血运丰富,首先行颈外动脉血管内栓塞治疗,然后经显微手术行脑膜瘤切除术,分析病人术后疗效及并发症等,总结治疗经验。结果 28例肿瘤全切除(Simpson分级Ⅰ、Ⅱ级)21例,次全切除(Simpson分级Ⅲ级)6例,部分切除(Simp-son分级Ⅳ级)1例。格拉斯哥预后分级(glascow out scale,GOS)Ⅰ级0例,Ⅱ级0例,Ⅲ级8例,Ⅳ级19例,Ⅴ级1例。结论完善术前评估及影像学检查,综合应用血管成像技术及栓塞术配合显微手术治疗血供丰富的内侧型蝶骨嵴脑膜瘤,对提高肿瘤切除程度,改善预后有积极意义。

Objective To explore the preoperative evaluation approach and microsurglcai technique of medial sphenoid ridge meningioma rich in blood supply. Methods Twenty eight patients with medial sphenoid ridge meningioma rich in blood supply treated in our hospital in the past five years were reviewed retrospectively. CT angiography （CTA） or digital subtraction angiography （DSA） were used to detect the blood supply of the tumors. Results Of 28 cases, total removal w as made in 21 cases, subtotal removal in 6 cases and partial removal in 1 case. Glasow out scale（GOS） gradeⅠand Ⅱ include 0 case, gradeⅢ includes 8 cases, grade IV includes 19 cases. Conclusion Complete preoperative evaluation and the combination of angiography and microsurgical treatment are of great help to the resection and prognosis of medial sphenoid ridge meningioma rich in blood supply.