【作者】 费舟； 蒋晓帆； 章翔； 高大宽； 刘恩渝；

【Author】 Fei Zhou,Jiang Xiaofan,Gao Dakuan,Liu Enyu Department of Neurosurgery,Xijing hospital,Fourth Military Medical University,Xi’an,710032

【机构】 第四军医大学西京医院神经外科；

【摘要】 目的:探讨侧方入路显微手术切除鞍区及鞍旁复杂型脑膜瘤的治疗效果。方法:手术入路根据肿瘤大小、位置、生长方式等影像学特点制定。侧方入路包括翼点及扩大翼点入路、颞下入路、经乙状窦前后入路。术中采用显微操作切除肿瘤,避免损伤下丘脑和重要的神经及血管等。结果:肿瘤全切除49例,近全除6例,部分切除3例,无手术死亡,无严重并发症。术前的神经功能症状均获得不同程度的改善。随访3个月～3年,5例复发。结论:正确运用侧方入路治疗鞍区及鞍旁复杂脑膜瘤可获得良好的治疗效果。正确、娴熟的显微外科操作是提高疗效,减少并发症的保证。更多还原

【Abstract】 Objective:To investigate the treatment effectiveness of the lateral approaches in the operations of the complicated sellar and parasellar meningiomas.Methods:The operative approach was decided by the size,the location and the iconography characteristics of the tumor.Lateral approaches include the pterional approach,the expand pterional approach,the subtemporal approach,anterior-posterior sigmoid sinus approach.Microneurosurgery technology must be used to avoid injuring hypothalamus and the important nerves and arteries.Results:Total resection had been performed on 49 patients,6 patients were processed by subtotal resection,only 3 patients were processed by partial resection,with no death or severe complications perioperatively.Clinical symptoms were mostly improved after operation.Recurrences of the tumor were found in only 5 patients by the follow-up from 3 months to 3 years.Conclusion:Good treatment effectiveness of the complicated sellar and parasellar meningiomas can be obtained by correct application of the lateral approaches.Perfect microneurosurgery technology is the key point for the success of the operation.更多还原