矢状窦旁脑膜瘤的手术治疗

Surgical treatment of parasagittal meningiomas

目的 探讨矢状窦旁脑膜瘤的手术方法和技巧。方法 回顾性分析 5 4例矢状窦旁脑膜瘤的临床资料。结果 手术全切肿瘤 5 1例 (94 .5 % ) ,其中SimpsonⅠ级切除者 2 2例 (40 .8% ) ,SimpsonⅡ级切除者 2 9例 (5 3.7% ) ;余 3例SimpsonⅢ级切除 (5 .5 % )。术后随访 6～ 72个月 ,无手术死亡。结论 矢状窦旁脑膜瘤的手术治疗应力争达到SimpsonⅠ级切除 ;充分的术前准备、良好的手术暴露、有效地控制术中出血。

Objective To discuss the operative techniques of parasagittal meningiomas.Methods A retrospective analysis was performed on 54 patients with parasagittal meningiomas.Results Simpson Ⅰ, Ⅱ and Ⅲ grade resection was achieved in 22(40.8%), 29(53.7%) and 3(5.5%) of the 54 patients in this series respectively . The follow up period ranged from 6～72 months. There were no postoperative deaths. Conclusion Simpson Ⅰ grade resection ought to be persued for parasagittal meningiomas. Sufficient preoperative preparation , adequate surgical exposure, efficient management of operative bleeding, protection and replacement of the sagittal sinus, and avoidence of damage to the brain tissues are the important factors to improve the rate of surgical resection and overall outcomes in patients with parasagittal meningiomas.