【摘要】 目的探讨伴瘤周水肿脑膜瘤患者瘤周水肿的形成机制及手术治疗策略。方法对87例经显微手术治疗的伴瘤周水肿脑膜瘤患者的临床资料进行回顾性分析。结果显微镜下肿瘤全切(SimpsonⅠ～Ⅱ级)75例,次全切及大部分切除(SimpsonⅢ、Ⅳ级)12例,无手术死亡及严重并发症发生。本组失随访9例,其余78例平均随访30个月,复发4例。结论根据肿瘤的部位、大小、瘤周水肿和占位效应的程度在术前、术中合理使用脱水药和激素;再根据术中的脑组织肿胀、糜烂、搏动、重要静脉保护的情况决定骨瓣的还纳与否,并辅以良好的术后管理,可取得良好的手术效果。更多还原

【Abstract】 Objectives To summarize the experiences in treating meningiomas with peritumorous edema by surgery.Method The clinical data of 87 patients with meningiomas with peritumorous edema,who underwent microsurgery from August,2005 to August,2009,were analysed retrospectively.Results Of 87 patients with menigiomas,75 received total resection (Simpson grades Ⅰ ～Ⅱ) resection,12 subtotal and greatly part (grades Ⅳ～Ⅲ).Death and severe complications did not occur in all the patients.The mean time of follow up was 30 months in 78 patients.The tumors recurred in 4 patients during the follow up period.Conclusions The dehydrating agents and hormones should be properly used before and/or during the surgery according to tumorous location and size,and extent of peritumorous edema.The removal or retention of the bone flaps should be dependent on the condition of the brain swelling,erosion and pulsation,and the protection of the cerebral veins.Beside of the above-mentioned,the good postoperative management is high important to the prognosis in the patients with meningiomas.更多还原