外科手术治疗蝶骨嵴内1/3脑膜瘤25例临床分析

Surgical Treatment of Meningioma in the Inner 1/3 Part of Sphenoid Wing: A Clinical Analysis of 25 Cases

目的：提高蝶骨嵴内１／３脑膜瘤的全切率、降低死亡率。方法：分析了１９８５～１９９６年间治疗的２５例蝶骨嵴内１／３脑膜瘤，其中１８例行显微外科治疗，术中根据肿瘤与视神经、颈内动脉的解剖关系，将肿瘤分为两型，即Ⅰ型：推挤型；Ⅱ型：包绕型。手术按Ｓｃｉｎｐｓｏｎ的脑膜瘤手术分级标准进行，７例行非显微外科治疗。结果：２５例中达ＳｉｍｐｓｏｎⅠ、Ⅱ、Ⅲ级全切除２１例，其中Ⅰ型全切除１４例，Ⅱ型全切除７例。死亡４例：其中非显微手术组３例，显微手术组１例。结论：了解肿瘤与颈内动脉、视神经的关系，了解肿瘤的供血特点，良好的手术入路及显微外科治疗，可取得较好的手术效果。

Objective:To raise the total removal rate and reduce the mortality of meningioma in the inner 1/3 part of sphenoid wing.Methods:Twenty patients with meningioma treated in our hospital from 1985 to 1996 were analysed.Of them 18 were treated microsurgically.Based on the anatomical relations of the tumor with the optic nerve and carotid artery,the meningiomas in the inner 1/3 part of sphenoid wing were classified into two types (:compressed and :encased).The operations were performed according to Simpson’s standard of grading in the operation of meningioma.Results:Twenty one of the 25 patients received total resection of Simpson’s ,and grades,including 14 of grade and 7 of grade .Four patients died after operation,being one patient in the microsurgical group and three in the nonmicrosurgical group.Conclusion:To understand the relation of tumor with optical nerve and carotid artery,to understand the characteristics of blood supply of the tumor and to adopt favorable operative approaches and microsurgery,good results will be achieved.