40例脑膜瘤显微镜下的手术治疗体会

• 作 者: 刘旭 廖洪民 朱家伟 匡涛 雷琳 黄建军 郑涛
• 机 构: 贵州航天医院神经外科,
• 出 处: 现代预防医学
• 发表日期: 2011年13期
• 关键词: 脑膜瘤 Simpson 镜下治疗 显微镜 复发率 蝶骨嵴 不同部位 脑干梗死 显微外科 大面积脑梗塞

[目的]探讨显微镜下治疗脑膜瘤的手术经过及体会。[方法]总结分析2007年1月～2010年1月显微镜下治疗脑膜瘤的临床资料。[结果]40例脑膜瘤患者死亡2例,死亡率5,治愈率95(38/40)。Simpson切除分级I级共19例,占47.5,II级共18例,占45.0,III级3例,7.5。不同部位的肿瘤全切率比较,差异无统计学意义(P﹥0.05)。且脑膜瘤术后患者死亡率及随访后的复发率比较,差异也有统计学意义(P﹥0.05)。其中蝶骨嵴部位的脑膜瘤术后1例出现死亡,死亡原因为血管痉挛大面积脑梗塞;小脑幕区的脑膜瘤术后1例出现死亡,死亡原因为术后脑干梗死死亡。[结论]对脑膜瘤行显微外科手术时根据脑膜瘤部位不同选择合适手术方法和入路,尽量全切肿瘤,提高临床治疗效果,降低死亡及复发率。

[Objective] To discuss the operation and experience of treating meningiomas under microscope. [Methods] The clinical data of patients with meningioma under microscope were summarized and analyzed from January 2007 to January 2010. [Results] Two patients died of meningioma in 40 cases, the mortality rate was 5 and the cure rate was 95 (38/40). Simpson resection grade I grade a total of 19 cases, accounting for 47.5, II grade a total of 18 cases, accounting for 45.0, III grade in 3 cases, 7.5. There was no significant difference in tumor resection rate between different sites (P> 0.05). The mortality of patients with meningioma and follow-up of the recurrence rate, the difference was statistically significant (P> 0.05). Including the sphenoid ridge of meningioma postoperative death occurred in 1 case, the cause of death was vasospasm large area cerebral infarction; cerebellar meningioma area after 1 case of death occurred after surgery, the cause of death was the death of brain stem infarction. [Conclusion] For meningiomas undergoing microsurgery, appropriate surgical methods and approaches should be chosen according to the location of meningioma. The tumor should be totally resected to improve the clinical effect and reduce the rate of death and recurrence.