岩斜区巨大脑膜瘤手术治疗的临床疗效分析

发布时间：2018-03-12 11:27

  本文选题：岩斜区　切入点：巨大脑膜瘤　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨岩斜区巨大脑膜瘤的手术方法及术后临床疗效分析,总结术后患者的神经功能恢复率及切除率。本研究对于岩斜区脑膜瘤手术入路及治疗后所引起的相关并发症和患者术后生活质量评定,来寻找一种更为有效、安全的手术方法。方法回顾性分析于2012年1月至2016年12月在郑州大学第一附属医院神经外科56例岩斜区巨大脑膜瘤患者的临床资料,其中男性18人,女性38人,平均年龄49.8岁。本研究肿瘤最大直径大于4.5cm。肿瘤的发病部位的起始为岩斜区,本研究中全部患者均行手术切除肿瘤。根据患者的基本发病情况,本研究病例手术方法分以下几种:经颞下-岩骨前行手术的有14例,经枕下-乙状窦后手术方法的有26例,扩大翼点行手术的有6例,经岩骨-乙状窦前幕上下联合行手术的有10例。术后观察所有患者神经功能修复的程度,随访时间3-30月。结果Petroclival MeningiomaS(PCMS)切除程度分级:Simpson I级,24例,Simpson II级12例,Simpson III级8例,Simpson IV级,12例。术后并发症引起的面瘫:3例;三叉神经痛:2例;饮水呛咳:3例;吞咽困难:4例;听力下降:4例;声音嘶哑:1例。结论根据肿瘤大小、质地、根基的部位等情况选择不同的手术入路,在切除肿瘤的同时应保护好周围重要的神经与血管,而不是肿瘤的全切率,尽量避免术后患者并发症的发生。其中枕下-乙状窦后入路术后对患者的并发症较小、生活质量评定好。
[Abstract]:Objective to investigate the surgical method and clinical effect of giant meningioma in petroclival region. To summarize the recovery rate and excision rate of postoperative neurologic function in patients with petroclival meningioma, this study was aimed to find a more effective method for evaluating the postoperative complications and quality of life of patients with petroclival meningioma. Methods from January 2012 to December 2016, the clinical data of 56 patients with giant meningioma in petroclival region of Zhengzhou University from January 2012 to December 2016 were retrospectively analyzed, including 18 males and 38 females. The mean age was 49.8 years. In this study, the maximum diameter of tumor was greater than 4.5 cm. The site of the tumor originated from the petroclival region. All the patients in this study underwent surgical resection of the tumor. The operative methods of this study were as follows: 14 cases underwent subtemporal and petrosal surgery, 26 cases underwent suboccipital and sigmoid sinus surgery, and 6 cases underwent enlarged pterygoid operation. There were 10 patients who underwent combined operation through the petrous bone and anterior tentorial sigmoid sinus. After operation, the degree of nerve function repair was observed in all patients. Results the resectable degree of Petroclival Meningioma sphincter was divided into 24 cases of Petroclival Simpson I grade and 12 cases of III grade 鈪，

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