颅底中央区脑膜瘤术后复发影响因素的研究
发布时间：2018-10-05 11:16
【摘要】：目的：研究颅底中央区脑膜瘤的临床特点,探讨显微手术治疗后肿瘤复发的影响因素。 资料和方法：回顾性分析中南大学湘雅医院神经外科1993年12月至2013年9月由袁贤瑞教授主刀手术的414例颅底中央区脑膜瘤患者的临床资料并进行随访研究。主要包括：一般资料、临床特征、影像学表现、手术资料、病理结果、有无复发等。对可能影响患者肿瘤术后复发的影响因素分别进行统计学分析。 414例患者首次手术全切336例,其中男性108例,女性228例,男女比例1：2.11,首次发病年龄6-79岁,平均47.50岁,首次发病病程1天-20年,中位数5.9月。临床表现以颅高压起病患者147例,以癫痫起病40例,以局部压迫症状起病的182例,以精神改变或智力下降起病的患者28例。首次手术术中行Simpson Ⅰ级切除患者77例,术中行Simpson Ⅱ级切除患者259例。病理等级为WHO Ⅰ级患者319例,WHO Ⅱ级患者12例,WHO Ⅲ级患者5例。鞍结节及鞍隔脑膜瘤组共有患者150例,前床突及蝶骨嵴内侧脑膜瘤组114例,岩斜坡及岩斜蝶脑膜瘤组62例,海绵窦组10例。 结果：首次手术肿瘤全切除患者336例,全切除后复发39例,占11.6%。术中行Simpson Ⅰ级切除患者肿瘤复发率(2.6%)低于术中行Simpson Ⅱ级患者复发率(14.3%)；肿瘤病理等级越高,患者复发率越高；肿瘤基底起源于海绵窦或和海绵窦关系密切的肿瘤患者术后复发率较高。有骨质破坏、有瘤内坏死的颅底中央区脑膜瘤复发率较高。 结论：1.颅底中央区脑膜瘤复发的高危因素包括：患者发病年龄、术中切除程度、肿瘤病理等级、肿瘤位置、肿瘤形态、骨质变化、瘤周水肿、瘤内坏死。 2.对于脑膜瘤复发高危人群,术中应尽可能彻底切除肿瘤及受累及硬脑膜,可降低肿瘤复发率。
[Abstract]:Objective: to study the clinical features of meningioma in the central region of the skull base and to explore the influencing factors of tumor recurrence after microsurgical treatment. Materials and methods: the clinical data of 414 patients with meningioma in the central part of the skull base who were operated by Professor Yuan Xianrui from December 1993 to September 2013 in Xiangya Hospital of Central South University were retrospectively analyzed and followed up. Include: general data, clinical features, imaging manifestations, surgical data, pathological results, recurrence and so on. The factors that may affect the recurrence of tumor after operation were analyzed statistically. There were 336 cases of total operation in 414 patients, including 108 males and 228 females, the ratio of male to female was 1: 2.11. The first onset age was 6-79 years old (mean 47.50 years). The course of the first onset was from 1 day to 20 years, with a median of 5.9 months. The clinical manifestations included 147 cases of cranial hypertension, 40 cases of epilepsy, 182 cases of local compression, and 28 cases of mental disorder or mental retardation. There were 77 cases of Simpson 鈪，
本文编号：2253171
[Abstract]:Objective: to study the clinical features of meningioma in the central region of the skull base and to explore the influencing factors of tumor recurrence after microsurgical treatment. Materials and methods: the clinical data of 414 patients with meningioma in the central part of the skull base who were operated by Professor Yuan Xianrui from December 1993 to September 2013 in Xiangya Hospital of Central South University were retrospectively analyzed and followed up. Include: general data, clinical features, imaging manifestations, surgical data, pathological results, recurrence and so on. The factors that may affect the recurrence of tumor after operation were analyzed statistically. There were 336 cases of total operation in 414 patients, including 108 males and 228 females, the ratio of male to female was 1: 2.11. The first onset age was 6-79 years old (mean 47.50 years). The course of the first onset was from 1 day to 20 years, with a median of 5.9 months. The clinical manifestations included 147 cases of cranial hypertension, 40 cases of epilepsy, 182 cases of local compression, and 28 cases of mental disorder or mental retardation. There were 77 cases of Simpson 鈪，
本文编号：2253171
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