【摘要】 目的探讨内侧型蝶骨嵴脑膜瘤显微手术治疗方法及术后复发的相关因素。方法回顾性分析2008年至2014年显微手术治疗的61例内侧型蝶骨嵴脑膜瘤患者的临床资料,并应用Kaplan-Meier法、log-rank检验及Cox比例风险回归模型分析影响肿瘤术后复发的相关危险因素。结果肿瘤全部切除36例,部分切除25例。术后死亡2例。46例术后随访1~75个月,肿瘤复发18例,复发率39.1%。统计学分析显示肿瘤侵犯海绵窦或颅骨、包绕颈内动脉及其分支、恶性病理学特征及部分切除是肿瘤复发的独立危险因素。结论术中对肿瘤遵循去血管化、严格蛛网膜平面操作、尽可能实行原位切除等显微手术原则,可提高肿瘤的全切除率、最大程度减少术后复发率并获得满意的手术疗效。更多还原

【Abstract】 ObjectiveTo summarize the microsurgical technique of medial sphenoid wing meningiomas(m SWMs) and analyze the factors influencing their recurrence.MethodsThe clinical data of 61 patients with m SWMs treated by microsurgery in our hospital from January, 2008 to August, 2014 were analyzed retrospectively. The factors related to recurrence of m SWMs were analyzed by Kaplan-Meier method, log-rank test and Cox multivariate regression analysis.ResultsOf 61 patients with m SWMs, 36 received total resection of m SWMs and 25 part. Two patients died after the operation. The tumors recurred in 18 patients(39.1%) from 8 to 48 months after the operation. The statistical analyses showed that the independent risk factors of m SWMs recurrence included tumor invading the cavernous sinus or skull bone, or wrapping the intracranial carotid artery or its branches, atypical histopathological features and tumorous residue.ConclusionsThe good curative effects of microsurgery on m SWMs may be obtained by the tumorous devascularition,all the dissections within the arachnoidal planes and orthotopic resection of the tumors as far as possible, including the high rate of total resection of the tumors, low rate of the recurrence of the tumors and so on.更多还原