显微手术治疗矢状窦旁及大脑镰旁脑膜瘤的疗效研究

发布时间：2018-06-06 01:24

  本文选题：脑膜瘤 + 矢状窦　； 参考：《中国全科医学》2017年17期

【摘要】：目的探讨采用显微手术切除矢状窦旁及大脑镰旁脑膜瘤的操作要点和疗效。方法回顾性分析2008年1月—2015年5月山东省医学科学院附属医院神经外科收治的46例矢状窦旁及大脑镰旁脑膜瘤患者的临床资料,其中矢状窦和大脑镰前1/3段肿瘤13例、中1/3段肿瘤29例、后1/3段肿瘤4例;肿瘤基底位于矢状窦16例,大脑镰22例,矢状窦和大脑镰同时受累8例。46例患者均行显微手术治疗。结果按Simpson脑膜瘤切除分级标准:Ⅰ级32例,Ⅱ级9例,Ⅲ级4例,Ⅳ级1例。病理分型:内皮细胞型20例,纤维型12例,砂粒型6例,血管型4例,混合型2例,不典型性2例。无手术死亡患者;16例术前肌力减退者中,14例术后肌力改善,1例术后偏瘫加重,1例无变化。41例随访1~8年,9例癫痫患者中癫痫未再发作6例,肿瘤复发3例,行放疗2例,再次手术1例。结论完善术前影像学检查,设计手术入路及术中策略,控制出血,保护和处理矢状窦和引流静脉及功能区脑皮质,是提高矢状窦旁及大脑镰旁脑膜瘤手术疗效的重要因素。
[Abstract]:Objective to study the operative points and curative effect of microsurgical resection of parafilar and paraspinal meningiomas of the sagittal sinus. Methods from January 2008 to May 2015, the clinical data of 46 patients with para-sagittal sinus and paraspinal meningioma, including 13 cases of sagittal sinus and 1 / 3 segment of cerebral falx, were retrospectively analyzed in the neurosurgery department of affiliated Hospital of Shandong Academy of Medical Sciences. 29 cases of middle 1 / 3 segment tumors, 4 cases of posterior 1 / 3 segment tumors, 16 cases of tumor base located in sagittal sinus, 22 cases of cerebral falx, 8 cases of sagittal sinus and 8 cases of cerebral falx were treated by microsurgery. Results according to Simpson's criteria of meningioma resection, 32 cases were grade 鈪，

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