小脑幕脑膜瘤的诊断和外科治疗
发布时间：2019-03-29 10:00
【摘要】：目的：通过对小脑幕脑膜瘤的解剖学特点、流行病学特点、临床表现、影像学检查、诊断和手术方案选择、术中静脉窦处理、术后并发症、病理结果及随访等加以分析讨论,以期提高小脑幕脑膜瘤的认识、诊断和手术治疗水平。 研究对象和方法：本文收集了2010年1月～2014年1月期间山东大学齐鲁医院收治的62例小脑幕脑膜瘤病例,针对其诊断与手术治疗进行了回顾性分析。本组所有病人均行CT和MRI检查,17例行MRA检查,1例行脑血管造影加栓塞术。 结果：62例患者中男14例、女48例,平均年龄约为55.35岁,平均病程22.9个月。首发的临床症状以头痛、肢体共济失调、恶心呕吐和视力视野改变为主。手术入路根据患者情况选择,手术全切率(SimpsonⅠ级和Ⅱ级切除)69.49%,术后并发症以术后感染和皮下积液为主,未有长期并发症出现。手术相关死亡率1.62%。获得随访的32例患者未有复发病例。 结论： 1.小脑幕脑膜瘤的早期无临床特异表现,早期诊断困难,晚期主要以颅内压增高表现和颅神经损害表现,诊断以影像学检查为主要依据。 2.术前建议同时行CT和MRI以对比,必要时行MRA检查明确静脉窦受累情况。常规不推荐脑血管造影检查,除非术前需行栓塞治疗。 3.术中静脉窦应仔细处理,不宜强行切除侵入静脉窦内肿瘤。手术总体全切率较高,效果满意,死亡率低,可出现短期或长期并发症。
[Abstract]:Objective: to analyze and discuss the anatomic features, epidemiological features, clinical manifestations, imaging examination, diagnosis and surgical scheme selection, intraoperative venous sinus management, postoperative complications, pathological results and follow-up of tentorial meningiomas. In order to improve the understanding, diagnosis and surgical treatment of tentorial meningioma. Subjects and methods: 62 cases of tentorial meningioma were collected from January 2010 to January 2014 in Qilu Hospital of Shandong University. The diagnosis and surgical treatment of tentorial meningioma were analyzed retrospectively. All the patients were examined by CT and MRI, 17 cases by MRA and 1 case by angiography and embolization. Results: there were 14 males and 48 females with an average age of 55.35 years and a mean course of disease of 22.9 months. The initial clinical symptoms were headache, limb ataxia, nausea and vomiting, and visual field changes. According to the patient's condition, the total resection rate (Simpson 鈪，
本文编号：2449418
[Abstract]:Objective: to analyze and discuss the anatomic features, epidemiological features, clinical manifestations, imaging examination, diagnosis and surgical scheme selection, intraoperative venous sinus management, postoperative complications, pathological results and follow-up of tentorial meningiomas. In order to improve the understanding, diagnosis and surgical treatment of tentorial meningioma. Subjects and methods: 62 cases of tentorial meningioma were collected from January 2010 to January 2014 in Qilu Hospital of Shandong University. The diagnosis and surgical treatment of tentorial meningioma were analyzed retrospectively. All the patients were examined by CT and MRI, 17 cases by MRA and 1 case by angiography and embolization. Results: there were 14 males and 48 females with an average age of 55.35 years and a mean course of disease of 22.9 months. The initial clinical symptoms were headache, limb ataxia, nausea and vomiting, and visual field changes. According to the patient's condition, the total resection rate (Simpson 鈪，
本文编号：2449418
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