CAJ | 학술논문

目的探讨前颅底及蝶骨嵴脑膜瘤的手术切除方法和技巧. 方法回顾性分析安徽医科大学附属安庆医院神经外科自1998年7月至2008年4月收治的33例前颅底及蝶骨嵴脑膜瘤患者的临床资料,其中手术采用经单侧额下入路4例,双侧额下入路17例,翼点入路5例,改良翼点入路7例. 结果术中肿瘤全切除30例,次全切除2例,大部分切除1例.术后症状改善28例,但出现偏瘫失语1例,精神症状1例,死亡1例,复发2例. 结论术前通过影像学检查评估肿瘤的位置及与颅底、血管、神经的关系来选择不同的手术入路,术中精细操作以加强对血管、神经的保护是提高肿瘤全切除率,降低致残率、死亡率和复发率的关键.
목적 탐토전로저급접골척뇌막류적수술절제방법 화기교. 방법 회고성분석안휘의과대학부속안경의원신경외과자1998년7월지2008년4월수치적33례전로저급접골척뇌막류환자적림상자료,기중수술채용경단측액하입로4례,쌍측액하입로17례,익점입로5례,개량익점입로7례. 결과 술중종류전절제30례,차전절제2례,대부분절제1례.술후증상개선28례,단출현편탄실어1례,정신증상1례,사망1례,복발2례. 결론 술전통과영상학검사평고종류적위치급여로저、혈관、신경적관계래선택불동적수술입로,술중정세조작이가강대혈관、신경적보호시제고종류전절제솔,강저치잔솔、사망솔화복발솔적관건.
Objective To review the surgical approach and skills of craniotomy for resecting anterior cranial base and sphenoidal ridge meningioma. Methods The clinical data of 33 patients with anterior cranial base and sphenoidal ridge meningioma treated between July, 1998 and April, 2008 were analyzed retrospectively. The meningioma was resected via the unilateral subfrontai approach in 4 cases, via the bilateral subfrontal approach in 17 cases, via the pterion approach in 5 cases and via modified ptetion approach in 7 cases. Results Total resection of the meningioma was achieved in 30 cases, subtotal resection in 2 cases and partial resection in 1 case. The clinical symptoms were improved after the operation in 28 cases. One patient showed paralytic aphonia, 1 developed hemiplegia, 1 had psychiatric symptom, 1 died and 2 experienced tumor relapse after the operation. Conclusion The selection of appropriate surgical approach according to the location of the tumor in relation to the skull base, blood vessels and nerves before the operation, careful operation and protection of the blood vessels and nerves during the operation are crucial to reduce the rate of disability, mortality and tumor recurrence following surgical resection of anterior cranial base and sphenoidal ridge meningioma.