摘要
目的探讨非颅底区脑膜瘤各种手术入路和操作技巧,以提高手术治疗效果。方法回顾性总结分析46例非颅底区脑膜瘤临床表现、影像学特征、手术入路选择、显微操作技巧和疗效。结果本组46例(大脑凸面10例、矢状窦旁16例、大脑镰旁12例、小脑凸面4例、小脑幕3例、多发性脑膜瘤1例)除2例肿瘤与中央沟静脉粘连紧密行Simpson III级切除,其余均为Simpson I、II级切除。术后出血需再次手术2例,中枢感染1例,经治疗好转。均痊愈出院。结论合理的手术入路,良好暴露和清晰的视野是手术成功的关键;较大肿瘤先行囊内切除,尽量在无牵张力下分离瘤脑界面;非颅底脑膜瘤应在第一次手术时做到完全切除,同时不损伤正常脑组织。
Objective To discuss the different surgery approach and operation skill of meningioma located in non-skull base area for the treatment progress. Methods To study retrospectively the clinical manifestation ,imageologic character, approach determination ,microsurgery skill and outcome of 46 cases meningiomas not belong to skull-base area. Results All 46 cases,including 10 cases at convex of cerebrum,16 cases at para-sigittal sinus area,12 cases at para-falx area,4 cases at convex of cerebellum,3 cases at tentorium of cerebellum,and meningiomatosis in one case,got Simpson Ⅰ.Ⅱ resection,except 2 cases with tight connection with rolando vein got Simpson Ⅲ resection.In which 2 cases got secondary operation for intracranial bleeding after operation,intracranial infection happened in 1 case and got recovered finally. Neither complication nor death happened in this group. Conclusion The reasonable choice of approach, good exposure and clear surgery field during operation are great importance in successful operation. For large tumor intra-sac resection is necessary at the beginning. And the tumor should be dissected at the interface between normal brain tissue and tumor at no-tension state. The meningioma at non-skull base area should be removed completely at first operation as well as normal brain tissue is protected.
出处
《中国现代医药杂志》
2008年第8期4-6,共3页
Modern Medicine Journal of China
关键词
脑膜瘤
非颅底区
开颅手术
Meningioma Non-skull base area Craniotomy
