中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2012年
4期
327-332
,共6页
张俊廷%李达%郝淑煜%王亮%林久銮%杨阳%汤劼%肖新如%吴震%张力伟
張俊廷%李達%郝淑煜%王亮%林久鑾%楊暘%湯劼%肖新如%吳震%張力偉
장준정%리체%학숙욱%왕량%림구란%양양%탕할%초신여%오진%장력위
脑膜瘤%岩斜区%乙状窦前%预后%经岩骨入路
腦膜瘤%巖斜區%乙狀竇前%預後%經巖骨入路
뇌막류%암사구%을상두전%예후%경암골입로
MeHningioma%Petroclival%Presigmoid%Prognosis%Transpetrosal approach
目的 分析岩斜区脑膜瘤手术治疗及长期预后.方法 回顾性分析426例岩斜区脑膜瘤临床资料并进行随访,采用KPS评分对术前后状况进行评估,并对预后及远期生存相关因素进行分析.结果 有效随访314例,男85例,女229例,术前KPS评分72.9±10.5.主要手术入路为经岩骨乙状窦前入路(53.5％),肿瘤大小为(4.1±1.0)cm,全切53.8％(Simpson Ⅰ或Ⅱ级),手术死亡率2.1％,术后KPS评分为65.5 ±16.1.平均随访71.2个月,复发28例,死亡23例.随访KPS评分为74.2±28.2.术前KPS评分、肿瘤与脑干粘连和与血管神经关系等均为预后KPS(≥80分)和远期生存的独立因素.5年、10年和15年的总生存率分别为93.0％、90.6％和70.0％.结论 手术为首选治疗策略.以保留患者神经功能和改善预后生活质量为前提,行个体化治疗,未全切者应规律复查,以决定是否辅助放疗.复发病例则应积极治疗.
目的 分析巖斜區腦膜瘤手術治療及長期預後.方法 迴顧性分析426例巖斜區腦膜瘤臨床資料併進行隨訪,採用KPS評分對術前後狀況進行評估,併對預後及遠期生存相關因素進行分析.結果 有效隨訪314例,男85例,女229例,術前KPS評分72.9±10.5.主要手術入路為經巖骨乙狀竇前入路(53.5％),腫瘤大小為(4.1±1.0)cm,全切53.8％(Simpson Ⅰ或Ⅱ級),手術死亡率2.1％,術後KPS評分為65.5 ±16.1.平均隨訪71.2箇月,複髮28例,死亡23例.隨訪KPS評分為74.2±28.2.術前KPS評分、腫瘤與腦榦粘連和與血管神經關繫等均為預後KPS(≥80分)和遠期生存的獨立因素.5年、10年和15年的總生存率分彆為93.0％、90.6％和70.0％.結論 手術為首選治療策略.以保留患者神經功能和改善預後生活質量為前提,行箇體化治療,未全切者應規律複查,以決定是否輔助放療.複髮病例則應積極治療.
목적 분석암사구뇌막류수술치료급장기예후.방법 회고성분석426례암사구뇌막류림상자료병진행수방,채용KPS평분대술전후상황진행평고,병대예후급원기생존상관인소진행분석.결과 유효수방314례,남85례,녀229례,술전KPS평분72.9±10.5.주요수술입로위경암골을상두전입로(53.5％),종류대소위(4.1±1.0)cm,전절53.8％(Simpson Ⅰ혹Ⅱ급),수술사망솔2.1％,술후KPS평분위65.5 ±16.1.평균수방71.2개월,복발28례,사망23례.수방KPS평분위74.2±28.2.술전KPS평분、종류여뇌간점련화여혈관신경관계등균위예후KPS(≥80분)화원기생존적독립인소.5년、10년화15년적총생존솔분별위93.0％、90.6％화70.0％.결론 수술위수선치료책략.이보류환자신경공능화개선예후생활질량위전제,행개체화치료,미전절자응규률복사,이결정시부보조방료.복발병례칙응적겁치료.
Objective To analyze the long- term surgical outcomes and prognostic factors of petroclival meningiomas.Methods Clinical data of 426 cases of petroclival meningiomas were retrospectively analyzed and followed - up to evaluate the prognostic factors of outcomes and long - term survival.The pre - and post - operative status of patient was evaluated by Karnofsky Performance Scale (KPS).Results After a mean follow- up duration of 71.2 months,314 patients (85 males and 229 females) were included in the recent study with a mean preoperative KPS of 72.9 ± 10.5.The most frequent approach was presigmoid transpetrosal approach (53.5％),complete resection (Simpson Grade Ⅰ or Ⅱ ) was achieved in 53.8％ patients,and the surgical mortality was 2.1％.Postoperative KPS at discharge and at recent evaluation was 65.5 ± 16.1and 74.2 ± 28.2 respectively.Recurrence was found in 28 patients and 23 patients died during follow - up.Preoperative KPS,relationships between tumor and brain stem,vessels and nerves were independent prognostic factors of recent KPS and long - term survival.The overall survival rates were 93.0％ at 5 years,90.6％ at 10,and 70.0％ at 15 years.Conclusions Surgical treatment was the first and the best option for petroclival meningiomas.With regard of neurological function and life quality,gross total resection and individual treatment should be achieved as far as possible.Patients with incomplete resection should be followed - up with MRI scan regularly to decide whether to undergoradiotherapy.Aggressive treatment should be administered for patients with recurrence.
