颞下-乙状窦后联合锁孔入路显微手术治疗岩斜区巨大脑膜瘤的效果观察

Observation on the effect of subtemporal and retrosigmoid sinus combined with keyhole approach in the treatment of giant meningioma in diagenetic region

目的 :观察用颞下-乙状窦后联合锁孔入路显微手术治疗岩斜区巨大脑膜瘤的临床效果。方法 :选取2017年1月至2017年12月期间乐山市人民医院收治的30例岩斜区巨大脑膜瘤患者为研究对象。对这30例患者均采用颞下-乙状窦后联合锁孔入路显微手术进行治疗。治疗结束后,观察其手术的效果、术后并发症的发生情况及远期恢复的效果。结果 :在这30例患者中,有86.67%的患者其肿瘤被全部切除,有13.33%的患者其肿瘤被次(近)全切除。术后有23.33%的患者出现新的颅神经功能障碍或其原有的神经功能障碍症状加重,有3.33%的患者出现肢体无力加重的现象,有3.33%的患者出现脑干出血,经保守治疗后均痊愈出院。术前及术后3个月这30例患者KPS的评分相比,P>0.05。术后6个月对这30例患者进行随访的结果显示,有93.33%患者的健康状况为良好。术后1年,这30例患者的病情均未复发。结论 :用颞下-乙状窦后联合锁孔入路显微手术治疗岩斜区巨大脑膜瘤安全有效,可显著改善患者的预后和健康状况。

objective:to observe the clinical effect of subtemporal retrosigmoid sinus combined with keyhole approach in the treatment of giant meningioma in the petroclinal area.Methods:30 patients with giant meningiomas in the petroclinal area admitted to the people*s hospital of leshan city from January 2017 to December 2017 were selected as the study subjects.All 30 patients were treated by microsurgery via subtemporal and retrosigmoid sinus combined with keyhole approach.After the treatment,the effect of the operation,the occurrence of postoperative complications and the long-term recovery were observed.Results:of the 30 patients,86.67%had their tumors removed completely,and 13.33% had their tumors removed subtotal.After the operation,23.33%of the patients had new cranial nerve dysfunction or their original nerve dysfunction symptoms increased,3.33% of the patients had limb weakness increased,3.33%of the patients had brain stem bleeding,after conservative treatment,all recovered and discharged.The KPS score of 30 patients before and 3 months after surgery was P>0.05.The results of follow-up of the 30 patients 6 months after the operation showed that 93.33% of the patients were in good health.One year after surgery,none of the 30 patients had relapsed.Conclusion:subtemporalretrosigmoid sinus combined with keyhole approach is safe and effective in the treatment of giant meningioma in the petroclinal region,and can significantly improve the prognosis and health status of patients.