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[背景 ]总结分析脑膜瘤的手术入路和显微外科手术效果 ,探讨如何提高全切率、降低手术死残率、改善手术效果 .[病例报告 ]回顾性分析自 1997年 11月至 2 0 0 1年 9月间的 5 8例脑膜瘤病例 ,采用 6种手术入路行显微外科手术治疗 ,包括翼点入路 4例 ,经额下入路 2例 ,跨矢状线入路 2 4例 ,乳突后枕下入路 5例 ,枕下正中 寰椎入路 2例 ,按肿瘤部位入路 2 1例 .5 8例病人中切除脑膜瘤共 61个 ,术后CT复查示全切 5 2例 ( 90 % ) ,次全切除 2例 ( 3 % ) ,大部切除 4例 ( 7% ) .术后恢复良好 4 3例 ( 74 % ) ,好转 9例 ( 16% ) ,术后新增颅神经损伤 4例 ( 8% ) ,死亡 2例 ( 4 % ) .[讨论 ]根据肿瘤的大小和部位 ,选择恰当的手术入路 ,熟悉显微神经解剖关系 ,熟练应用手术技巧能够提高肿瘤的全切率、降低手术死残率
[Background] To summarize and analyze the surgical approaches and microsurgical results of meningioma, and to explore how to increase the rate of complete cutting, reduce the rate of surgical death and improve the effect of surgery. [Case Report] A retrospective analysis was performed from November 1997 to February 2010 Fifty-eight cases of meningioma between September and September 2001 underwent microsurgery with six surgical approaches, including 4 cases of pterional approach, 2 cases of transapical approach, 2 4 cases, suboccipital posterior suboccipital approach in 5 cases, suboccipital inferior midline atlantoaxial approach in 2 cases, according to the tumor site approach 21 cases .5 8 cases of resection of meningioma in a total of 61 postoperative CT review showed 5 cases (90%) were cut, 2 cases (3%) were subtotally resected, and 4 cases (7%) were mostly resected.Postoperative recovery was good in 43 cases (74%) and improvement in 9 cases After the addition of cranial nerve injury in 4 cases (8%), died in 2 cases (4%). [Discussion] According to the size and location of the tumor, select the appropriate surgical approach, familiar with the anatomy of the nerve, skilled surgical skills can Improve the rate of tumor resection and reduce the rate of surgical death