窦旁脑膜瘤的显微手术治疗分析

Analysis of microsurgical treatment for sinus meningioma

目的分析窦旁脑膜瘤显微手术治疗效果。方法窦旁脑膜瘤患者28例,用显微手术方法进行治疗,分析患者的影像学资料和手术效果。结果 10例Ⅰ级切除,占35.71%,15例为Ⅱ级切除,占53.58%,1例为Ⅲ级切除,占3.57%,2例为Ⅳ级切除,占7.14%。患者术后均无头痛症状,7例单侧感觉障碍症状好转,8例一过性下肢瘫痪症状缓解,1例精神症状缓。术后1例出现瘤腔出血,对该患者进行对症治疗后恢复正常;8例患者术后出现肢体肌力下降,经对症治疗后均有不同程度的恢复;1例患者术后出现新发癫痫,术前伴发癫痫患者均恢复。患者术后Karnofsky评分为(76.89±5.83)分,术前为(87.24±5.72)分,两组比较,差异有统计学意义(P<0.05);对所有患者进行随访,术后1年内无肿瘤复发患者,术后1年6个月和2年5个月分别有2例复发。结论窦旁脑膜瘤患者用显微手术治疗,可有效提高肿瘤切除成功率,保护颅内组织结构,降低并发症发生率。

Objective To analyze the efficacy of microsurgical treatment for sinus meningioma. Method The imaging data and operation results of 28 cases of sinus meningioma were analyzed. Results There were 10 cases（35.71% ） of grade I resection, 15 cases（53.58% ） of grade Ⅱ resection, Ⅰ case （3.57%） of grade Ⅲ resection,and 2 cases（7.14% ）of grade IV resection. After the surgery, no patient had headache. Seven cases of unilateral sensory dysfunction, eight cases of transient paralysis of the lower limb, and one case of mental symptoms were improved. One patient with postoperative tumor cavity bleeding was healed after symptomatic treatment. Eight patients with degenerated nmscle strength were recovered at different degrees after related treatment. One patient had a newly discovered epilepsy but other patients with preoperative epilepsy were all healed. The Karnofsky score was raised from （ 76.89 ± 5.83 ） points to （ 87.24 ± 5.72） points （ P 〈 0.05 ）. During the follow-up period, no patient had a recurrence with- in 12 months. One patient had a recurrence at the 18th month and one had a recurrence at the 29th month. Conclusion Microsurgery can effectively improve the success rate of tumor resection, protect indi- vidual brain structure, and reduce the incidence of complications for meningioma patients