颅内巨大脑膜瘤的显微手术治疗

Microsurgery for intracranial giant meningiomas(report of 12 cases)

目的探讨颅内巨大脑膜瘤的显微手术切除技巧。方法回顾性分析2000年1月至2013年7月手术治疗的12例颅内巨大脑膜瘤患者的临床资料。结果 12例颅内巨大脑膜瘤中,SimpsonⅠ级切除5例,Ⅱ级切除7例;无死亡病例。术前肿瘤栓塞4例。9例术后随访6～36个月,生活均能自理,1例复发后再次手术。结论应用显微神经外科技术切除肿瘤是治疗颅内巨大脑膜瘤的有效方法,术前影像学充分评估及肿瘤供血动脉栓塞、围手术期激素及抗癫痫药物等应用、并发症防治等有助于提高巨大脑膜瘤的疗效。

Objective To investigate the microsurgical techniques and comprehensive treatment of intracranial giant meningiomas. Method The clinical data of 12 patients with intracranial giant meningiomas who underwent microsurgery in our hospital from January, 2000 to July, 2013 were analyzed retrospectively. Results Of 12 patients with intracranial giant meningiomas, 5 received Simpson Grade Ⅰ resection of the tumors and 7 Grade Ⅱ. No patient died ＇from the surgery. Four patients underwent preoperative endovascular embolization of the arteries feeding blood to the tumors All of 9 patients followed up from 6 to 36 months could take good care of themselves in living. One patient underwent the second operation because of the relapse of the meningioma. Conclusions Microsurgery should be performed in the patients with intracranial giant meningiomas. The preoperative sufficient evaluation of the tumors by imaging and endovascular embolization of the arteries feeding blood to the tumors, application of hormone and anti-epilepsy drugs during the peroperative period, and prevention and treatment of postoperative complications are very helpful to improvement of prognoses in the patients with intracranial giant meningiomas.