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目的探讨显微外科手术治疗鞍结节脑膜瘤的手术入路及技巧。方法回顾性分析32例鞍结节脑膜瘤的临床资料。其中,行单侧额下入路11例,翼点或扩大翼点入路11例,额外侧入路4例,眶上锁孔入路3例,经额底前纵裂入路3例。结果肿瘤全切除28例,其中SimpsonⅠ级3例,SimpsonⅡ级25例;肿瘤次全切除4例。术后视力改善11例,无明显变化10例,视力下降7例,4例昏迷者未做视力检查。结论术前早期诊断,选择合适手术入路及术中精细的显微外科操作是取得良好手术效果的保证。
Objective To investigate the surgical approach and technique of microsurgical treatment of saddle nodular meningiomas. Methods Retrospective analysis of 32 cases of saddle nodular meningioma clinical data. Among them, 11 patients underwent unilateral lower frontal approach, 11 patients had wing points or enlarged pterional approach, 4 had extra lateral approach, 3 had supraorbital keyhole approach, and 3 had antegrade posterior longitudinal approach. Results Totally resected tumors were 28 cases, including 3 cases of Simpson grade Ⅰ and 25 cases of Simpson Ⅱ grade; 4 cases of subtotal tumor resection. Postoperative visual acuity improved in 11 cases, no significant change in 10 cases, vision loss in 7 cases, 4 cases of coma without vision examination. Conclusion Early preoperative diagnosis, selection of appropriate surgical approach and intraoperative fine microsurgery operation is to ensure good surgical results.