【摘要】 目的对124例鞍旁及鞍上脑膜瘤手术治疗结果进行回顾性分析。方法根据肿瘤主体所在部位不同而采取不同的手术入路,术中采用显微操作切除肿瘤。适当病例术前进行栓塞,残余肿瘤采取γ-刀治疗。结果肿瘤位于鞍旁86例,鞍上38例。全切71例,大部切除30例,部分切除23例。术前栓塞13例,术后γ-刀治疗32例。术后95例有不同程度的神经功能、视力改善,死亡8例。随访3个月～14年,22例复发。结论根据肿瘤大小与部位选择合理的手术入路和显微外科操作有助于提高疗效,减少并发症。鞍旁脑膜瘤应首选翼点入路,鞍上脑膜瘤首选经额入路。更多还原

【Abstract】 Objective To evaluate the operative results, we study 124 meningiomas cases involving different parts of sellar region retrospectly. Methods Various operative approaches were chosen for different kinds of meningiomas in this area. Preoperative selective embolization followed by microsurgical resection, and selective postoperative γ-knife treatment was performed. Results 86 parasellar and 38 suprasellar tumors were resected via pterional transsylvian, anterior interhemispheric, frontal approach. Total resection was achieved in 71 cases, subtotal resection in 30 and partly removal in 23 patients. 8 died after operation. Superselective embolization was perfumed for 13 cases. 32 patients got postoperative γ-knife treatment. 95 patients had significant visual and neurologic improvment. During the follow-up period ranged from 3 months to 14 years, 22 tumors recurred. Conclusion The appropriate approaches selection according the size and site of tumors and microsurgical procedure can lead to significant vision improvement, overall outcome and decrease complications. Pterional approach is the first choice for parasellar meningioma, and transfrontal approach may be the best for suprasellar meningiomas.更多还原