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目的探讨天幕脑膜瘤的临床特点与显微手术治疗体会。方法15例天幕脑膜瘤病人术前行CT 平扫加增强扫描,9例行MRI 检查。依照肿瘤与天幕关系分别采用颞顶枕、顶枕、枕下、顶枕-枕下联合入路,显微镜下切除肿瘤。结果按照Simpson肿瘤切除分级标准:Ⅰ级切除10例,Ⅱ级切除3例,Ⅲ级切除2例,无手术死亡及严重并发症。随访12例,2例复发,再次手术获治愈。结论天幕脑膜瘤手术切除可获较好的生活质量和较长生存时间。正确选择手术入路、控制瘤体出血、分块切除、保护重要脑功能是完成肿瘤切除应遵循的基本原则。显微手术有助于提高肿瘤全切率,减少复发,降低并发症。
Objective To investigate the clinical features and microsurgical treatment of meningiomas. Methods Fifteen patients with ameloblastoma underwent preoperative CT scan and contrast enhanced scan, and 9 underwent MRI scan. According to the relationship between the tumor and the canopies, the temporal top and top occipital, suboccipital and top occipital-occipital combined approach were respectively used. The tumors were removed under the microscope. Results According to the Simpson tumor resection and grading standards, there were 10 cases of grade Ⅰ excision, 3 cases of grade Ⅱ excision and 2 cases of grade Ⅲ excision. There was no operative death and serious complications. Follow-up in 12 cases, 2 cases of recurrence, re-operation was cured. Conclusion Aneurysm meningioma surgery can get better quality of life and longer survival time. Correct choice of surgical approach, control of tumor bleeding, sub-block removal, protection of important brain function is to complete the tumor resection should follow the basic principles. Microsurgery can help improve the rate of tumor resection, reduce recurrence and reduce complications.