摘要
目的探讨鞍结节脑膜瘤的手术入路和手术技巧,以改善手术治疗的效果。方法回顾性分析1985年1月至2004年12月手术治疗的鞍结节脑膜瘤47例,根据CT和MRI的表现,将其分为大、中、小三型,采用4种不同的手术入路,比较全切除率、手术结果和并发症发生情况。结果47例肿瘤中,获全切除44例,次全切除3例。肿瘤的全切除率与肿瘤大小和手术入路无关(P>0.05)。手术后恢复良好者43例;中度致残2例;重残1例;死亡1例,死亡率2.1%。手术结果与肿瘤大小和手术入路无关(P>0.05)。结论大多数鞍结节脑膜瘤可以完全及安全地切除,小、中型肿瘤宜采用眶上匙孔入路,中、大型肿瘤宜采用单侧额下或翼点侧裂入路,大型肿瘤或侵犯肿瘤视神经管者宜采用眶颧入路切除肿瘤。不管采用何种入路,切除肿瘤的技术是相同的,也是全切除肿瘤的关键。
Objective To inquire surgical approaches and techniques of tuberculum sellae meningiomas in order to improve the operative effect. Methods A retrospective analysis was made on 47 cases of tuberculum sellae meningioma operated. The tumors operated on with 4 different surgical approaches were classified into large, middle and small types depending upon its size on CT or MRI, with the comparison of total resection rate, operative results and complications among the types. Results Of 47 cases, tumor was total removed in 44cases, subtotal in 3cases. Total resection rate is no relationship with size of tumors and operative approaches （ P 〉 0.05 ）. Postoperatively, patients recovered well in 43 cases, mild disable in 2 cases, severe disable in 1 case, and dead in 1 case, with mortality of 2.1%. Operative results are no relationship with size of tumors and operative approaches （ P 〉 0. 05 ）. Conclusion Tuberculum sellae meningiomas can be removed completely and safely with higher total resection rate, less postoperative complications and better operative results in majority of cases. The more appropriate approaches are the supraorbital keyhole approach in small and middle types, the unilateral subfrontal or pterional approach in middle and large types and the frontotemporal orbitozygomatic approach in large type. Whichever operative approach was used, the techniques of removing meningioma were same, and were the key to total remove it.
出处
《中华神经外科杂志》
CSCD
北大核心
2007年第9期646-649,共4页
Chinese Journal of Neurosurgery
关键词
鞍结节
脑膜瘤
手术入路
手术技术
Tuberculum sellae
Meningioma
Operative approach
Operative technique
